Research

Prediction of post-operative necrosis after mastectomy: A pilot study utilizing optical diffusion imaging spectroscopy

Roshni Rao¹ , Michel Saint-Cyr² , Aye Moe Thu Ma¹ , Monet Bowling¹ , Daniel A Hatef² , Valerie Andrews¹ , Xian-Jin Xie³ , Theresa Zogakis¹ and Rod Rohrich²

¹  Department of Surgery, Division of Surgical Oncology, University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9155, USA

²  Department of Plastic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9155, USA

³  Department of Clinical Sciences-Division of Biostatistics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9155, USA

author email corresponding author email

World Journal of Surgical Oncology 2009, 7:91doi:10.1186/1477-7819-7-91

Published:	25 November 2009

Abstract

Introduction

Flap necrosis and epidermolysis occurs in 18-30% of all mastectomies. Complications may be prevented by intra-operative detection of ischemia. Currently, no technique enables quantitative valuation of mastectomy skin perfusion. Optical Diffusion Imaging Spectroscopy (ViOptix T.Ox Tissue Oximeter) measures the ratio of oxyhemoglobin to deoxyhemoglobin over a 1 × 1 cm area to obtain a non-invasive measurement of perfusion (StO₂).

Methods

This study evaluates the ability of ViOptix T.Ox Tissue Oximeter to predict mastectomy flap necrosis. StO₂ measurements were taken at five points before and at completion of dissection in 10 patients. Data collected included: demographics, tumor size, flap length/thickness, co-morbidities, procedure length, and wound complications.

Results

One patient experienced mastectomy skin flap necrosis. Five patients underwent immediate reconstruction, including the patient with necrosis. Statistically significant factors contributing to necrosis included reduction in medial flap StO₂ (p = 0.0189), reduction in inferior flap StO₂ (p = 0.003), and flap length (p = 0.009).

Conclusion

StO₂ reductions may be utilized to identify impaired perfusion in mastectomy skin flaps.