Prolonged and severe tissue hypoxia results in
tissue necrosis in pedicled flaps. We demonstrate the potential of near-
infrared spectroscopy for predicting viability of compromised tissue portions. This approach clearly identifies tissue regions with
low oxygen supply, and also the severity of this challenge, in a rapid and non-invasive manner, with a high degree of reproducibility. Tissues remaining below a certain
hemoglobin oxygen saturation threshold (
oxygen saturation index <1) for prolonged periods (>6 h) became increasingly dehydrated, eventually becoming visibly necrotic. Tissues above this threshold (
oxygen saturation index >1), despite being significantly hypoxic relative to the pre-elevation saturation values, remained viable over the 72 h post-elevation monitoring period. The magnitude of the drop in
tissue oxygen saturation, as observed immediately following
surgery, correlated with the final clinical outcome of the flap tissue. These results indicate the potential of
near infrared spectroscopy and imaging to monitor
tissue oxygenation status and assess
tissue viability following
reconstructive surgery. Early, nonsubjective detection of poor
tissue oxygenation following
surgery increases the likelihood that intervention aimed at saving the tissue will be successful.