Near-infrared Spectroscopy-guided Flap Delay: For Flap Training and Timing of Pedicle Division
Staged pedicled flaps continue to be a safe and effective technique for reconstructing complex wounds when free tissue transfer is not possible. To induce ischemic preconditioning, serial cross-clamping of the pedicle is performed, which is also known as flap training. Current protocols for flap tra...
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| Format: | Article |
| Language: | English |
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Japan Society of Plastic and Reconstructive Surgery
2025-01-01
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| Series: | Journal of Plastic and Reconstructive Surgery |
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| Online Access: | https://www.jstage.jst.go.jp/article/jprs/4/1/4_2023-0063/_pdf/-char/en |
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| _version_ | 1832568634791165952 |
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| author | Sally SJ Chan Chong H Pek Yijun Wu Yuan Kong Wei M Ho Jolie JY Hwee |
| author_facet | Sally SJ Chan Chong H Pek Yijun Wu Yuan Kong Wei M Ho Jolie JY Hwee |
| author_sort | Sally SJ Chan |
| collection | DOAJ |
| description | Staged pedicled flaps continue to be a safe and effective technique for reconstructing complex wounds when free tissue transfer is not possible. To induce ischemic preconditioning, serial cross-clamping of the pedicle is performed, which is also known as flap training. Current protocols for flap training are based on arbitrary schedules of progressively increasing periods of ischemia. We describe a simple, safe, and reproducible technique of using near-infrared spectroscopy to objectively guide the process of pedicle cross-clamping and aid in determining the optimal timing for flap division. This technique enables surgeons to adopt a more aggressive clamping schedule based on objective parameters, tailors the clamping schedule to the physiologically tolerable limits of each flap, and allows for early flap division. The principles, feasibility, and advantages of using near-infrared spectroscopy to guide pedicled flap training and early flap division are discussed. |
| format | Article |
| id | doaj-art-4da50f51560c401db83d61237e256efc |
| institution | Kabale University |
| issn | 2436-259X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Japan Society of Plastic and Reconstructive Surgery |
| record_format | Article |
| series | Journal of Plastic and Reconstructive Surgery |
| spelling | doaj-art-4da50f51560c401db83d61237e256efc2025-02-03T00:52:48ZengJapan Society of Plastic and Reconstructive SurgeryJournal of Plastic and Reconstructive Surgery2436-259X2025-01-014157602023-0063Near-infrared Spectroscopy-guided Flap Delay: For Flap Training and Timing of Pedicle DivisionSally SJ Chan0Chong H Pek1Yijun Wu2Yuan Kong3Wei M Ho4Jolie JY Hwee5Division of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Khoo Teck Puat HospitalDivision of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Khoo Teck Puat HospitalDivision of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Khoo Teck Puat HospitalDivision of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Khoo Teck Puat HospitalDivision of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Khoo Teck Puat HospitalDivision of Plastic, Reconstructive and Aesthetic Surgery, Department of General Surgery, Khoo Teck Puat HospitalStaged pedicled flaps continue to be a safe and effective technique for reconstructing complex wounds when free tissue transfer is not possible. To induce ischemic preconditioning, serial cross-clamping of the pedicle is performed, which is also known as flap training. Current protocols for flap training are based on arbitrary schedules of progressively increasing periods of ischemia. We describe a simple, safe, and reproducible technique of using near-infrared spectroscopy to objectively guide the process of pedicle cross-clamping and aid in determining the optimal timing for flap division. This technique enables surgeons to adopt a more aggressive clamping schedule based on objective parameters, tailors the clamping schedule to the physiologically tolerable limits of each flap, and allows for early flap division. The principles, feasibility, and advantages of using near-infrared spectroscopy to guide pedicled flap training and early flap division are discussed.https://www.jstage.jst.go.jp/article/jprs/4/1/4_2023-0063/_pdf/-char/enflap delayflap trainingischemic preconditioningreconstructive surgerynear-infrared spectroscopy |
| spellingShingle | Sally SJ Chan Chong H Pek Yijun Wu Yuan Kong Wei M Ho Jolie JY Hwee Near-infrared Spectroscopy-guided Flap Delay: For Flap Training and Timing of Pedicle Division Journal of Plastic and Reconstructive Surgery flap delay flap training ischemic preconditioning reconstructive surgery near-infrared spectroscopy |
| title | Near-infrared Spectroscopy-guided Flap Delay: For Flap Training and Timing of Pedicle Division |
| title_full | Near-infrared Spectroscopy-guided Flap Delay: For Flap Training and Timing of Pedicle Division |
| title_fullStr | Near-infrared Spectroscopy-guided Flap Delay: For Flap Training and Timing of Pedicle Division |
| title_full_unstemmed | Near-infrared Spectroscopy-guided Flap Delay: For Flap Training and Timing of Pedicle Division |
| title_short | Near-infrared Spectroscopy-guided Flap Delay: For Flap Training and Timing of Pedicle Division |
| title_sort | near infrared spectroscopy guided flap delay for flap training and timing of pedicle division |
| topic | flap delay flap training ischemic preconditioning reconstructive surgery near-infrared spectroscopy |
| url | https://www.jstage.jst.go.jp/article/jprs/4/1/4_2023-0063/_pdf/-char/en |
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