In the first human clinical trial, researchers at Massachusetts General Hospital (MGH) and surgeons at Beth Israel Deaconess Medical Center (BIDMC) have tested the practicality and reliability of felt bandage. oxygen which measures the density of oxygen in a transplanted tissue. The test, published in Advances in science, compared to a novel performance, a paint bandage made with phosphorescent materials to a threaded cloth oximeter (ViOptix device) – the standard for monitoring the oxidation of tissue – in women undergoing reconstructive surgery breast after cancer.
Our test showed that the transparent liquid bandage detects the oxidation of tissue in addition to the gold standard oximeter, which uses old technology, is uncomfortable for the patient, hinders visual inspection of the fabric, and can to give false readings based on light conditions and their patient movements. The standalone bandage is a major improvement over the use of a wired oximeter that restricts patient movements and is complex. “
Conor L. Evans, PhD, lead paper author and principal investigator at the Wellman Center for Photomedicine at MGH
The research team accepted the challenge of building a better muscle oxidation sensor following a request from the Department of Defense that sought to reduce failure rates of fine transplant surgeries and skin adhesion in wounded soldiers. The technology behind the band was developed with support from the Military Medical Photonics Program. The test tests the bandage in breast reconstruction, a common type of free flap transplant surgery in which plastic surgeons remove skin, fat, arteries and blood vessels from the patient’s abdomen and microsurgically reconnecting the material and vessels to the chest.
“Up to 5% of free flap surgery can fail, usually within 48 hours of surgery, if there is a rupture or insufficient blood flow to the transplanted tissue. added, which is a terrible result, “said Samuel J. Lin, MD, MBA, plastic surgeon and regenerative surgeon at BIDMC and senior author. By monitoring the amount of oxygen getting to the material that is transmitted, surgeons can quickly detect a vascular problem and intervene to save the referral.
Five breast reconstructed women were enrolled in the trial from March to September 2017. The liquid bandage was painted in a 1 cm by 1 cm area on seven transplanted flaps ( two women had reconstructed both breasts). Each flap was also fitted with a wireless oximeter, and print oxidation was monitored for 48 hours after surgery. The bandage measures the amount of oxygen reaching the ingredient itself, while the ViOptix reads the amount of oxygen saturation in the blood by near-infrared spectroscopy – a less accurate measure of vital blood flow. for the transmission.
In this study, a research clinician photographed the band with a digital camera with standard filters after surgery. The flame from the camera picked up the phosphorescent material in the band, which then shone red to green based on the amount of oxygen present in the band. Since then Evans and colleagues have developed a battery-powered sensor head for the bandage that eliminates the need for the camera and makes the bandage self-contained. The prototype study was published in Biomedical Optics Express.
In the seven flaps, the rate of oxidation change in cloth was measured by the band attached to the oximeter, and all seven flaps were successful. The researchers are currently planning a clinical trial to examine how well the bandage detects a flap that fails with a lack of oxygen.
“The potential of a wireless oxygen monitoring device for blood flow could be a game changer,” says Lin.
Clinical applications for an oxygen-sensory bandage may include wound healing, tight transmissions for trauma, skin burns for burns, limbs affected by peripheral artery disease and chronic ischemia (blood flow). less). “The technology could also detect significant changes in tension in patients with heart disease and other medical conditions, providing an early warning signal that disease is developing,” says Lin. that there are other clinical practices that we have not yet considered. “
Source:
Massachusetts General Hospital
Magazine Reference:
Signals, H., et al. (2020) Paintable phosphorescent bandage for postoperative print oxygen assessment in DIEP flap reconstruction. Advances in science. doi.org/10.1126/sciadv.abd1061.