Optical Surgical Probe for Assessing Human Oral Mucosa Graft Vascularization

用于评估人体口腔粘膜移植物血管化的光学手术探针

• 批准号: 8712986
• 负责人: JAMES F CHRISTIAN
• 金额: $ 74.91万
• 依托单位: RADIATION MONITORING DEVICES, INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8712986
• 关键词: Anastomosis - action; Arteries; Beds; Blood; Blood Vessels; Blood Volume; Blood flow; Breast; Collaborations; Detection; Devices; Diffuse; Disorder by Site; Distant; Effectiveness; Excision; Facial Injuries; Failure; Family suidae; Goals; Gunshot wound; Head and Neck Cancer; Head and neck structure; Health; Hemoglobin; Human; Implant; Injury; Location; Malignant Neoplasms; Measurement; Measures; Michigan; Modeling; Monitor; Muscle; Operative Surgical Procedures; Optical Instrument; Optics; Oral mucous membrane structure; Outcome; Patients; Perfusion; Periosteum; Phase; Procedures; Reporting; Simulate; Site; Skin; Spectrum Analysis; Study models; Surface; Surgeon; Surgical Flaps; Survival Rate; Testing; Tissue Engineering; Tissue Grafts; Tissues; Vascularization; Veins; Work; Writing; artist; base; blood perfusion; bone; cancer surgery; capillary bed; commercialization; design and construction; feeding; hemodynamics; improved; instrument; monitoring device; phantom model; phase 2 study; pressure; programs; public health relevance; reconstruction; research clinical testing; response; vehicular accident

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: 1. At a feeding artery; 2. At the exiting vein; 3. Within the capillary bed of the fap; and 4. 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.

描述（由申请人提供）： 枪伤、机动车事故以及头颈部或乳房癌症手术可能会造成毁灭性和毁容性的面部损伤。最先进的重建手术涉及远距离转移组织，包括骨、骨膜、皮肤、肌肉和脉管系统，然后通过显微外科手术将预先存在的血管吻合到移植组织，称为游离或埋藏皮瓣。我们建议开发一种光学仪器来定量监测重建组织的血液灌注和氧合。放置在组织移植物内（或顶部）的四个光纤组织补片连接到血流动力学监测仪，测量每个位置的氧合和血流量： 1. 在供血动脉； 2. 出口静脉处； 3. fap毛细血管床内； 4.在皮肤表面。每个探头将为外科医生提供血管流量、总血容量（血红蛋白浓度）和血氧的直接测量。这些测量将使显微外科医生从皮瓣健康的主观、非定量评估转变为皮瓣健康的直接定量测量。 将进行两种猪模型研究。第一项研究涉及手术创建一个游离皮瓣，其中包含一条用于流入的动脉和一条用于流出的静脉。一种适用的封堵装置 明确的闭塞量（动脉或静脉）将用于闭塞血管，同时在皮瓣内的四个不同部位同时获得血流和氧合测量：动脉、静脉、在皮瓣床内和皮肤处。这些研究将是简短的非生存程序。在第二项研究中，将创建包含植入光学装置的组织瓣，并用于在术后一周内像以前一样监测四个部位的皮瓣活力。