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Article

Is Hyperspectral Imaging Suitable for Assessing Collateral Circulation Prior Radial Forearm Free Flap Harvesting? Comparison of Hyperspectral Imaging and Conventional Allen’s Test

1
Department of Oral–and Maxillofacial and Plastic Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
2
Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacher Straße 170, 56072 Koblenz, Germany
3
Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes-Gutenberg-University Mainz, 55131 Mainz, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally.
Academic Editor: Andreas Arkudas
J. Pers. Med. 2021, 11(6), 531; https://doi.org/10.3390/jpm11060531
Received: 16 May 2021 / Revised: 4 June 2021 / Accepted: 8 June 2021 / Published: 9 June 2021
(This article belongs to the Special Issue Plastic and Reconstructive Surgery in Personalized Medicine)
(1) Background: This cross-sectional study aims to compare a new and non-invasive approach using hyperspectral imaging (HSI) with the conventional modified Allen’s test (MAT) for the assessment of collateral perfusion prior to radial forearm free flap harvest in healthy adults. (2) HSI of the right hand of 114 patients was recorded. Here, three recordings were carried out: (I) basic status (perfusion), (II) after occlusion of ulnar and radial artery (occlusion) and (III) after releasing the ulnar artery (reperfusion). At all recordings, tissue oxygenation/superficial perfusion (StO2 (0–100%); 0–1 mm depth), tissue hemoglobin index (THI (0–100)) and near infrared perfusion index/deep perfusion (NIR (0–100); 0–4 mm depth) were assessed. A modified Allen’s test (control) was conducted and compared with the HSI-results. (3) Results: Statistically significant differences between perfusion (I) and artery occlusion (II) and between artery occlusion (II) and reperfusion (III) could be observed within the population with a non-pathological MAT (each <0.001). Significant correlations were observed for the difference between perfusion and reperfusion in THI and the height of the MAT (p < 0.05). Within the population with a MAT >8 s, an impairment in reperfusion was shown (each p < 0.05) and the difference between perfusion and reperfusion exhibited a strong correlation to the height of the MAT (each p < 0.01). (4) Conclusions: The results indicate a reliable differentiation between perfusion and occlusion by HSI. Therefore, HSI could be a useful tool for verification of the correct performance of the MAT as well as to confirm the final diagnosis, as it provides an objective, reproducible method whose results strongly correlate with those obtained by MAT. What is more, it can be easily applied by non-medical personnel. View Full-Text
Keywords: hyperspectral imaging; Allen’s test; radial forearm free flap; microvascular surgery; microsurgery; reconstructive surgery; perfusion monitoring; flap imaging hyperspectral imaging; Allen’s test; radial forearm free flap; microvascular surgery; microsurgery; reconstructive surgery; perfusion monitoring; flap imaging
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MDPI and ACS Style

Heimes, D.; Becker, P.; Thiem, D.G.E.; Kuchen, R.; Kyyak, S.; Kämmerer, P.W. Is Hyperspectral Imaging Suitable for Assessing Collateral Circulation Prior Radial Forearm Free Flap Harvesting? Comparison of Hyperspectral Imaging and Conventional Allen’s Test. J. Pers. Med. 2021, 11, 531. https://doi.org/10.3390/jpm11060531

AMA Style

Heimes D, Becker P, Thiem DGE, Kuchen R, Kyyak S, Kämmerer PW. Is Hyperspectral Imaging Suitable for Assessing Collateral Circulation Prior Radial Forearm Free Flap Harvesting? Comparison of Hyperspectral Imaging and Conventional Allen’s Test. Journal of Personalized Medicine. 2021; 11(6):531. https://doi.org/10.3390/jpm11060531

Chicago/Turabian Style

Heimes, Diana, Philipp Becker, Daniel G.E. Thiem, Robert Kuchen, Solomiya Kyyak, and Peer W. Kämmerer. 2021. "Is Hyperspectral Imaging Suitable for Assessing Collateral Circulation Prior Radial Forearm Free Flap Harvesting? Comparison of Hyperspectral Imaging and Conventional Allen’s Test" Journal of Personalized Medicine 11, no. 6: 531. https://doi.org/10.3390/jpm11060531

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