Optical Surgical Probe for Assessing Human Oral Mucosa Graft Vascularization

DESCRIPTION provided by applicant Devastating and disfiguring facial injuries can result from gunshot wounds and motor vehicle accidents as well as from cancer surgeries of the head and neck or breast The most advanced reconstructive procedures involve distant transfer of tissue including bone periosteum skin muscle and vasculature followed microsurgical anastomosis of pre existing blood vessels to the grafted tissue referred to as free or buried flaps We propose to develop an optical instrument that quantitative monitoring of reconstructive tissue blood perfusion and oxygenation Four fiberoptic tissue patches placed within or atop tissue grafts connect to the hemodynamic monitor measuring oxygenation and blood flow rate at each location At a feeding artery At the exiting vein Within the capillary bed of the fap and At the surface of the skin Each probe will provide the surgeon with direct measures of the rate of vascular flow total blood volume hemoglobin concentration and the blood oxygenation These measurements will enable the microsurgeon to transit from subjective non quantitative assessment of flap health to direct quantitative measurements of flap health Two pig model studies will be performed The first study involves surgical creation of a free flap containing a single artery for inflow and single vein for outflow An occluding device that applies a well defined amount of occlusion either to the artery or the vein will be used to occlude th vessels while blood flow and oxygenation measurements will be obtained simultaneously at four different sites within the flap at the artery at the vein within the flap bed and at the skin hese studies will be short non survival procedures In the second study tissue flaps will be created containing the implanted optical devices and be used to monitor the flap viability at the four site as before for one week post surgery PUBLIC HEALTH RELEVANCE We proposed to develop an optical instrument to quantitatively monitor the health of reconstructed tissue post surgery for devastating injuries and cancer procedures to the head neck and breast Such a device will significantly improve the outcome for these patients