Evidence map›Paper›PMID 30688880›Full record

Observational studyPlastic and reconstructive surgery2019

Intraoperative Tissue Perfusion Measurement by Laser Speckle Imaging: A Potential Aid for Reducing Postoperative Complications in Free Flap Breast Reconstruction.

Cynthia To, Jacqueline E Rees-Lee, Rodney J Gush, Kim M Gooding, Nicholas H Cawrse, Angela C Shore, Andrew D H Wilson

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Plastic and reconstructive surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. iScience · 2024
    Article
  2. Article
  3. Review
  4. Current and novel mapping substances in gynecologic cancer care.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2020
    Review
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Cynthia ToFrom the Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School; the Breast Care Unit, Torbay and South Devon NHS Foundation Trust, Torbay Hospital; the Department of Plastic Surgery, Royal Devon and Exeter NHS Foundation Trust; and Moor Instruments.
Jacqueline E Rees-LeeFrom the Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School; the Breast Care Unit, Torbay and South Devon NHS Foundation Trust, Torbay Hospital; the Department of Plastic Surgery, Royal Devon and Exeter NHS Foundation Trust; and Moor Instruments.
Rodney J GushFrom the Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School; the Breast Care Unit, Torbay and South Devon NHS Foundation Trust, Torbay Hospital; the Department of Plastic Surgery, Royal Devon and Exeter NHS Foundation Trust; and Moor Instruments.
Kim M GoodingFrom the Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School; the Breast Care Unit, Torbay and South Devon NHS Foundation Trust, Torbay Hospital; the Department of Plastic Surgery, Royal Devon and Exeter NHS Foundation Trust; and Moor Instruments.
Nicholas H CawrseFrom the Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School; the Breast Care Unit, Torbay and South Devon NHS Foundation Trust, Torbay Hospital; the Department of Plastic Surgery, Royal Devon and Exeter NHS Foundation Trust; and Moor Instruments.
Angela C ShoreFrom the Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School; the Breast Care Unit, Torbay and South Devon NHS Foundation Trust, Torbay Hospital; the Department of Plastic Surgery, Royal Devon and Exeter NHS Foundation Trust; and Moor Instruments.
Andrew D H WilsonFrom the Diabetes and Vascular Medicine Research Centre, NIHR Exeter Clinical Research Facility, University of Exeter Medical School; the Breast Care Unit, Torbay and South Devon NHS Foundation Trust, Torbay Hospital; the Department of Plastic Surgery, Royal Devon and Exeter NHS Foundation Trust; and Moor Instruments.

Funding

Medical Research Council MC_PC_14127
6 · The paper itself

Abstract

Adequate tissue perfusion is essential to minimize postoperative complications following microsurgery. Intraoperative knowledge of tissue perfusion could aid surgical decision-making and result in reduced complications. Laser speckle imaging is a new, noninvasive technique for mapping tissue perfusion. This article discusses the feasibility of using laser speckle imaging during free flap breast reconstruction and its potential to identify areas of inadequate perfusion, thus reducing surgical complications. Adult patients scheduled to undergo free flap breast reconstruction were recruited into the study. Laser speckle images were obtained from the abdominal and breast areas at different stages intraoperatively. Zonal perfusion was compared with the Holm classification and clinical observations. Twenty patients scheduled to undergo free flap breast reconstruction were recruited (23 reconstructed breasts) (mean age, 50 years; range, 32 to 68 years). Flap zonal perfusion was 238 (187 to 313), 222 (120 to 265), 206 (120 to 265), and 125 (102 to 220) perfusion units for zones I, II, III, and IV, respectively (analysis of variance, p < 0.0001). Zonal area with perfusion below an arbitrary perfusion threshold were 20 (0.3 to 75), 41 (3 to 99), 49 (9 to 97), and 99 (25 to 100) percent, respectively (analysis of variance, p < 0.0001). One example is presented to illustrate potential intraoperative uses for laser speckle imaging. This study shows that laser speckle imaging is a feasible, noninvasive technique for intraoperative mapping of tissue perfusion during free flap breast reconstruction. Zonal tissue perfusion was reduced across the Holm classification. Observations indicated the potential for laser speckle imaging to provide additional information to augment surgical decision-making by detection of inadequate tissue perfusion. This highlights the opportunity for surgeons to consider additional aids for intraoperative tissue perfusion assessment to help reduce perfusion-related complications. CLINICAL QUESTION/LEVEL OF EVIDENCE:: Diagnostic, IV.

Indexed as

Image Interpretation, Computer-AssistedAdultAgedAnalysis of VarianceBreast NeoplasmsCohort StudiesFeasibility StudiesFemaleFree Tissue FlapsHumansLaser-Doppler FlowmetryMammaplastyMastectomyMicrosurgeryMiddle AgedMonitoring, Intraoperative

Identifiers

PMID30688880

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.