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ID 105894
タイトル別表記
信頼性の高い持続的遊離皮弁モニタリングのための低温度下経皮的二酸化炭素分圧測定 : 動物実験と臨床経験
Flap Monitoring by TcPCO2
著者
安倍, 吉郎 徳島大学大学院医学研究科(外科系専攻) 徳島大学 教育研究者総覧 KAKEN研究者をさがす
Goishi, Keiichi The University of Tokushima
柏木, 圭介 The University of Tokushima
Yamano, Masahiro The University of Tokushima
資料タイプ
学位論文
抄録
Background: Measurement of transcutaneous oxygen pressure (TcPO2) and transcutaneous carbon dioxide pressure (TcPCO2) has been used for free flap monitoring. Because these values are obtained with sensor probes heated to 44°C, there is potential for low-temperature burns on skin flaps. We measured TcPO2 and TcPCO2 at 37°C in both animals and humans to determine the feasibility and safety of the procedure as a postoperative flap monitoring method.
Methods: Twelve epigastric island flaps were elevated in rabbits, and TcPO2 and TcPCO2 were measured at 37°C before and after ligation of the pedicles. In addition, TcPO2 and TcPCO2 at 37°C were measured in healthy men. Subsequently, the method was applied to postoperative monitoring of free flaps in 49 clinical cases.
Results: TcPO2 and TcPCO2 values were significantly affected by the experimental flap elevation. A rapid increase in TcPCO2 was observed with both arterial and venous occlusion. In the healthy men, TcPO2 and TcPCO2 were measurable at all skin surface sites. In the clinical cases of free flap transfer, TcPO2 values remained very low for at least 72 hours. TcPCO2 values ranged from 40 to 70 mmHg for 72 hours in more than 80% of cases. In 2 cases, TcPCO2 values increased to more than 90 mmHg, and exploration surgery was performed. These compromised flaps were saved by reanastomosis of the veins.
Conclusions: Continuous monitoring of TcPCO2 at 37°C can provide objective information and alert doctors and nurses to the need for checking the free flap.
掲載誌名
Plastic and Reconstructive Surgery : Global Open
ISSN
21697574
cat書誌ID
AA12786168
出版者
Wolters Kluwer Health
1
2
開始ページ
1
終了ページ
8
発行日
2013-05-13
備考
内容要旨・審査要旨・論文本文の公開:
内容要旨・審査要旨 : LID201310041001.pdf
内容要旨・審査要旨 : LID201406051002.pdf
本論文は, 著者Yoshiro Abeの学位論文として提出され, 学位審査・授与の対象となっている。
権利情報
PRS GO uses the Creative Commons License Attribution-NonCommercial No Derivative 3.0 License (CCBY-NC-ND) for all articles and content published.( https://creativecommons.org/licenses/by-nc-nd/3.0/ )
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
甲第2622号
学位記番号
甲医第1167号
学位授与年月日
2013-07-25
学位名
博士(医学)
学位授与機関
徳島大学
部局
医学系