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Pilot Clinical Study To Demonstrate The Feasibility Of Monitoring Subcutaneous Blood Flow Among Peri-operative Surgery Patients
Michael Neidrauer, Alec Lafontant, Vaishali Purohit, Elizabeth Mintz, Kaitlin Kelly, Dhriti Dedhia, Nataly Bingham, Brendan K. McCracken, Leonid Zubkov, Peter A. Lewin, Rose Ann DiMaria-Ghalili, Michael S. Weingarten.
Drexel University, Philadelphia, PA, USA.

Purpose: The purpose of this study was to demonstrate the feasibility of using non-invasive optical measurements of local microcirculatory blood flow as a screening tool for pressure injury (PI) among peri-operative surgery patients. Background: Surgery is a risk factor for PI, and an estimated 9-12% of PIs originate as deep tissue pressure injury (DTPI) beneath the skin's surface. DTI is not clinically apparent until it spreads through subcutaneous tissue and into the skin. By this time, the damage may be too extensive to avoid advanced ulceration. We previously reported that blood flow in dermal and subcutaneous tissue, measured using non-invasive optical diffuse correlation spectroscopy (DCS), could predict the development of advanced (Stage 2-4 or unstageable) sacral PIs prior to clinical appearance in a rehabilitation hospital setting. Methods: We enrolled 8 surgical patients (3 male, 5 female, 37-70 years of age) and measured subcutaneous blood flow from the sacral, ischial, and scapular regions immediately before and after surgery. Duration of surgical procedure, duration of anesthesia, patient positioning, medications, and other clinical, nutritional, and metabolic data were gathered. Results: Changes in pre-operative vs. post-operative sacral blood flow for subjects whose duration of surgery was greater than three hours (n=4) were significantly greater than blood flow changes in subjects in surgery for <3 hours (p<0.01). Conclusions: This study demonstrated the feasibility of using DCS to monitor changes in microcirculatory blood flow before and after surgery, and will inform the design of a larger clinical study of the effectiveness of DCS for early detection of DTPI among peri-operative patients. Acknowledgements: This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs, under Award No. W81XWH-14-1-0614. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department of Defense.

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