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VitalFlap
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Jan Pieter
Joris Tjeerd
Gerben Tjepkema
Jeroen Hoogenberg
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VitalFlap

The challenge

Woman who have surgery as part of their breast cancer treatment may choose to undergo breast reconstruction surgery to rebuild the shape and look of their breast. There are different types of breast reconstruction, one of which is using tissue from another pace on the body, so called flap. The (DIEP) flap procedure has become a routine procedure in reconstructive breast surgery. Due to advanced microsurgical techniques flap viability has improved significantly. Nevertheless, the failure of flaps due to problems at the site of the anastomosis still occurs in 6% to 25% of cases. The most critical period is usually the first 24 to 48 hours post-surgery, with salvage rates of 50%. The time interval between onset and surgical repair of a microvascular problem largely influences the success of re-procedure. Detecting first signs of postoperative flap failure and permit timely re-exploration is necessary to minimise the incidence of flap failure and its consequences. Current method for monitoring the reconstructed breast is clinical observation done by nurses every hour for the first few postoperative recovery days. However, this method is highly subjective and it is impossible for the hospital staff to observe the flap continuously.

The solution

A new monitoring device for continuous postoperative surveillance is being developed. This device is based on near infrared spectroscopy (NIRS), which is a well-known, non-invasive technique used in pulse oximeters. By measuring light absorbance tissue haemoglobin concentration can be derived, which reflects the status of tissue perfusion. By comparing these signals from the tissue of the reconstructed breast with a reference signal, a statement can be made about the flap’s vitality and as a result blood flow complications can be corrected before clinical signs are evident, so that the flap can be saved on time. This innovation will therefore replace the intensive schedule of frequent inspections by specialized nursing staff reducing workload and costs. Moreover, because the monitoring is carried out unnoticed and automatically, the patient is less frequent disturbed.

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