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Revascularization After H-plasty Reconstructive Surgery in the Periorbital Region Monitored With Laser Speckle Contrast Imaging

Berggren, Johanna LU orcid ; Castelo, Nazia LU ; Tenland, Kajsa LU ; Engelsberg, Karl LU ; Dahlstrand, Ulf LU ; Albinsson, John LU orcid ; Sheikh, Rafi LU orcid ; Lindstedt, Sandra LU and Malmsjö, Malin LU (2021) In Ophthalmic Plastic and Reconstructive Surgery 37(3). p.269-273
Abstract

BACKGROUND: H-plasty reconstructive surgery is commonly used to close defects after tumor excision in the periorbital region. Revascularization of the bipedicle skin flaps is essential for healing. However, it has not previously been possible to study this revascularization in humans due to the lack of noninvasive perfusion monitoring techniques. The aim was to monitor perfusion in H-plasty flaps during surgery and during postoperative follow-up, using laser speckle contrast imaging.

METHOD: H-plasty, i.e., bipedicle random advancement skin flaps, was used for reconstruction of the eyelids after tumor removal in 7 patients. The median length and width of the skin flaps were 13 mm (range, 8-20 mm) and 10 mm (range, 5-11 mm),... (More)

BACKGROUND: H-plasty reconstructive surgery is commonly used to close defects after tumor excision in the periorbital region. Revascularization of the bipedicle skin flaps is essential for healing. However, it has not previously been possible to study this revascularization in humans due to the lack of noninvasive perfusion monitoring techniques. The aim was to monitor perfusion in H-plasty flaps during surgery and during postoperative follow-up, using laser speckle contrast imaging.

METHOD: H-plasty, i.e., bipedicle random advancement skin flaps, was used for reconstruction of the eyelids after tumor removal in 7 patients. The median length and width of the skin flaps were 13 mm (range, 8-20 mm) and 10 mm (range, 5-11 mm), respectively. Blood perfusion was measured using laser speckle contrast imaging during surgery and at follow up 1, 3, and 6 weeks postoperatively, to monitor revascularization.

RESULTS: Immediately postoperatively, the perfusion in the distal end of the flaps had fallen to 54% (95% CI, 38%-67%). The perfusion then quickly increased during the healing process, being 104% (86%-124%) after 1 week, 115% (94%-129%) after 3 weeks, and 112% (96%-137%) after 6 weeks. There was no clinically observable ischemia or tissue necrosis.

CONCLUSIONS: Revascularization of the H-plasty procedure flaps occurs quickly, within a week postoperatively, presumably due to the existing vascular network of the flap pedicle, and was not dependent on significant angiogenesis. This perfusion study confirms the general opinion that H-plasty is a good reconstructive technique, especially in the periorbital region with its rich vascular supply.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Ophthalmic Plastic and Reconstructive Surgery
volume
37
issue
3
pages
5 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85106185999
  • pmid:32852371
ISSN
1537-2677
DOI
10.1097/IOP.0000000000001799
language
English
LU publication?
yes
id
a25d1e0d-34de-482e-b410-51f8b2f3c469
alternative location
https://journals.lww.com/op-rs/Abstract/9000/Revascularization_After_H_plasty_Reconstructive.97978.aspx
date added to LUP
2020-08-29 23:07:31
date last changed
2024-10-31 10:32:42
@article{a25d1e0d-34de-482e-b410-51f8b2f3c469,
  abstract     = {{<p>BACKGROUND: H-plasty reconstructive surgery is commonly used to close defects after tumor excision in the periorbital region. Revascularization of the bipedicle skin flaps is essential for healing. However, it has not previously been possible to study this revascularization in humans due to the lack of noninvasive perfusion monitoring techniques. The aim was to monitor perfusion in H-plasty flaps during surgery and during postoperative follow-up, using laser speckle contrast imaging.</p><p>METHOD: H-plasty, i.e., bipedicle random advancement skin flaps, was used for reconstruction of the eyelids after tumor removal in 7 patients. The median length and width of the skin flaps were 13 mm (range, 8-20 mm) and 10 mm (range, 5-11 mm), respectively. Blood perfusion was measured using laser speckle contrast imaging during surgery and at follow up 1, 3, and 6 weeks postoperatively, to monitor revascularization.</p><p>RESULTS: Immediately postoperatively, the perfusion in the distal end of the flaps had fallen to 54% (95% CI, 38%-67%). The perfusion then quickly increased during the healing process, being 104% (86%-124%) after 1 week, 115% (94%-129%) after 3 weeks, and 112% (96%-137%) after 6 weeks. There was no clinically observable ischemia or tissue necrosis.</p><p>CONCLUSIONS: Revascularization of the H-plasty procedure flaps occurs quickly, within a week postoperatively, presumably due to the existing vascular network of the flap pedicle, and was not dependent on significant angiogenesis. This perfusion study confirms the general opinion that H-plasty is a good reconstructive technique, especially in the periorbital region with its rich vascular supply.</p>}},
  author       = {{Berggren, Johanna and Castelo, Nazia and Tenland, Kajsa and Engelsberg, Karl and Dahlstrand, Ulf and Albinsson, John and Sheikh, Rafi and Lindstedt, Sandra and Malmsjö, Malin}},
  issn         = {{1537-2677}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{3}},
  pages        = {{269--273}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Ophthalmic Plastic and Reconstructive Surgery}},
  title        = {{Revascularization After H-plasty Reconstructive Surgery in the Periorbital Region Monitored With Laser Speckle Contrast Imaging}},
  url          = {{http://dx.doi.org/10.1097/IOP.0000000000001799}},
  doi          = {{10.1097/IOP.0000000000001799}},
  volume       = {{37}},
  year         = {{2021}},
}