Grant: Project Grant

Free tissue transfer (FTT) is a surgical procedure for reconstructing complex wounds after cancer removal or severe trauma and burns. This procedure involves taking skin, muscle, or bone along with the main blood supply from one body site and transplanting it to the surgical wound. If the blood supply to FTT is poor, the transplanted tissue can die shortly after surgery. If the problem with FTT blood supply is detected early, transplanted tissue can be saved before it dies by taking patients back to the operating room. Thus, early recognition of poor FTT blood supply is crucial for a successful operation. Currently, no reliable means for monitoring FTT blood supply exists. At hospitals, nurses and surgeons assess the blood supply to the tissue by visually inspecting the skin every hour for three days after surgery. Visual inspection, however, can be misleading and results in missing or delayed diagnosis of a compromised FTT when it is already impossible to save the transplanted tissue. It was acceptable to both patients and clinicians. Our team at the University of British Columbia has recently developed an optical sensor based on near-infrared spectroscopy (NIRS) for continuous monitoring of the FTT blood supply. We tested our sensor in a proof of principle study on five patients with promising results. This project aims to develop, validate, and introduce a novel clinical NIRS system for objective and continuous monitoring of FTT blood supply. We will develop an advanced wireless version of the FTT-NIRS sensor with machine-learning diagnostic software. We will conduct a pilot study on 20 patients and then move to a clinical trial on 40 patients to examine the ability of the FTT-NIRS system to continuously monitor FTT blood supply and detect FTT poor blood supply early. Incorporating an advanced FTT-NIRS system will decrease FTT failure rates, thus decreasing patient morbidity and healthcare costs associated with re-operations and secondary reconstructions.