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John Albinsson, MSc, PhD

John Albinsson

Research engineer

John Albinsson, MSc, PhD

Revascularization After H-plasty Reconstructive Surgery in the Periorbital Region Monitored With Laser Speckle Contrast Imaging

Author

  • Johanna Berggren
  • Nazia Castelo
  • Kajsa Tenland
  • Karl Engelsberg
  • Ulf Dahlstrand
  • John Albinsson
  • Rafi Sheikh
  • Sandra Lindstedt
  • Malin Malmsjö

Summary, in English

BACKGROUND: H-plasty reconstructive surgery is commonly used to close defects after tumor excision in the periorbital region. Revascularization of the bipedicle skin flaps is essential for healing. However, it has not previously been possible to study this revascularization in humans due to the lack of noninvasive perfusion monitoring techniques. The aim was to monitor perfusion in H-plasty flaps during surgery and during postoperative follow-up, using laser speckle contrast imaging.

METHOD: H-plasty, i.e., bipedicle random advancement skin flaps, was used for reconstruction of the eyelids after tumor removal in 7 patients. The median length and width of the skin flaps were 13 mm (range, 8-20 mm) and 10 mm (range, 5-11 mm), respectively. Blood perfusion was measured using laser speckle contrast imaging during surgery and at follow up 1, 3, and 6 weeks postoperatively, to monitor revascularization.

RESULTS: Immediately postoperatively, the perfusion in the distal end of the flaps had fallen to 54% (95% CI, 38%-67%). The perfusion then quickly increased during the healing process, being 104% (86%-124%) after 1 week, 115% (94%-129%) after 3 weeks, and 112% (96%-137%) after 6 weeks. There was no clinically observable ischemia or tissue necrosis.

CONCLUSIONS: Revascularization of the H-plasty procedure flaps occurs quickly, within a week postoperatively, presumably due to the existing vascular network of the flap pedicle, and was not dependent on significant angiogenesis. This perfusion study confirms the general opinion that H-plasty is a good reconstructive technique, especially in the periorbital region with its rich vascular supply.

Department/s

  • Ophthalmology Imaging Research Group
  • Ophthalmology, Lund
  • Clinical Sciences, Helsingborg
  • LUCC: Lund University Cancer Centre
  • StemTherapy: National Initiative on Stem Cells for Regenerative Therapy
  • Thoracic Surgery

Publishing year

2021-05-01

Language

English

Pages

269-273

Publication/Series

Ophthalmic Plastic and Reconstructive Surgery

Volume

37

Issue

3

Document type

Journal article

Publisher

Lippincott Williams & Wilkins

Topic

  • Ophthalmology
  • Surgery

Status

Published

Research group

  • Ophthalmology Imaging Research Group

ISBN/ISSN/Other

  • ISSN: 1537-2677