Indian Journal of Plastic Surgery
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Year : 2018  |  Volume : 51  |  Issue : 3  |  Page : 266--273

Intraoperative partial pressure of oxygen measurement to predict flap survival

Department of Burns, Plastic and Maxillofacial Surgery, Dr. Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India

Correspondence Address:
Dr. Ankit Gupta
Department of Burns, Plastic and Maxillofacial Surgery, PGIMER and RML Hospital, New Delhi - 110 001
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijps.IJPS_35_17

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Introduction: Flap monitoring using partial pressure of oxygen (pO2) is a proven modality. Instruments needed are expensive and are not readily available to a clinician. Here, pO2of flap has been determined using readily available and cheap methods, and a cut-off value is calculated which helps in predicting flap outcome. Methods and Results: Total 235 points on 84 skin flaps were studied. Capillary blood was collected from flap and fingertip using 1-ml syringes after at least 30 min of flap inset, and pO2analysed using blood gas analyser. Fall/change of pO2(difference of mean of pO2[diff-pO2]) was also calculated by subtracting the flap pO2from the finger pO2. Flap was monitored clinically in post-operative period and divided into two groups depending on its survival with Group 1 – dead points and Group 2 – alive points. pO2and diff-pO2amongst both the groups were compared and found to be statistically different (P = 0.0001). Cut-off value calculated for pO2was found to be <86.3 mmHg with a sensitivity of 100% and specificity of 89.05%. The difference of >68.503 mmHg of flap pO2compared from finger pO2was calculated as a cut-off with sensitivity of 94.12 and specificity of 79.60%. Conclusions: Flap areas having intra-operative pO2value <86.3 mmHG have higher chances (60.71%) of getting necrosis later. Similarly, if diff-pO2compared to fingertip is >68.5 mmHg, chances of those points getting necrosed in post-operative period are high.


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