Transcutaneous PCO2 Measurement at Low Temperature for Reliable and Continuous Free Flap Monitoring : Experimental and Clinical Study

• Material Type: 博士論文
• Title: Transcutaneous PCO2 Measurement at Low Temperature for Reliable and Continuous Free Flap Monitoring : Experimental and Clinical Study
• Author/Editor: Abe, Yoshiro; Hashimoto, Ichiro; Goishi, Keiichi; Kashiwagi, Keisuke; Yamano, Masahiro; Nakanishi, Hideki
• Author Heading: Abe, Yoshiro; Hashimoto, Ichiro; Goishi, Keiichi; Kashiwagi, Keisuke; Yamano, Masahiro; Nakanishi, Hideki
• Publication, Distribution, etc.: Wolters Kluwer Health
• Publication Date: 2013-05-13
• Publication Date (W3CDTF): 2013-05-13
• Alternative Title: 信頼性の高い持続的遊離皮弁モニタリングのための低温度下経皮的二酸化炭素分圧測定 : 動物実験と臨床経験; Flap Monitoring by TcPCO2
• Periodical title: Plastic and Reconstructive Surgery - Global Open
• No. or year of volume/issue: 1 2
• Volume: 1
• Issue: 2
• Pages: 1-8
• ISSN (Periodical Title): ISSN : 2169-7574
• Degree grantor/type: 徳島大学
• Date Granted: 2013-07-25
• Dissertation Number: 甲第2622号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Target Audience: 一般
• Note (General): Background: Measurement of transcutaneous oxygen pressure (TcPO2) and transcutaneous carbon dioxide pressure (TcPCO2) has been used for free flap monitoring. Because these values are obtained with sensor probes heated to 44°C, there is potential for low-temperature burns on skin flaps. We measured TcPO2 and TcPCO2 at 37°C in both animals and humans to determine the feasibility and safety of the procedure as a postoperative flap monitoring method. Methods: Twelve epigastric island flaps were elevated in rabbits, and TcPO2 and TcPCO2 were measured at 37°C before and after ligation of the pedicles. In addition, TcPO2 and TcPCO2 at 37°C were measured in healthy men. Subsequently, the method was applied to postoperative monitoring of free flaps in 49 clinical cases. Results: TcPO2 and TcPCO2 values were significantly affected by the experimental flap elevation. A rapid increase in TcPCO2 was observed with both arterial and venous occlusion. In the healthy men, TcPO2 and TcPCO2 were measurable at all skin surface sites. In the clinical cases of free flap transfer, TcPO2 values remained very low for at least 72 hours. TcPCO2 values ranged from 40 to 70 mmHg for 72 hours in more than 80% of cases. In 2 cases, TcPCO2 values increased to more than 90 mmHg, and exploration surgery was performed. These compromised flaps were saved by reanastomosis of the veins. Conclusions: Continuous monitoring of TcPCO2 at 37°C can provide objective information and alert doctors and nurses to the need for checking the free flap.
• Access Restrictions: インターネット公開
• Rights (production): PRS GO uses the Creative Commons License Attribution-NonCommercial No Derivative 3.0 License (CCBY-NC-ND) for all articles and content published.( https://creativecommons.org/licenses/by-nc-nd/3.0/ )
• Related Material (DOI): 10.1097/GOX.0b013e3182936cd0
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 徳島大学 : 徳島大学機関リポジトリ

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