{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T02:04:56Z","timestamp":1787623496647,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study assesses whether use of continuous noninvasive near\u2010infrared spectroscopy (NIRS) sensor on head and neck free flap (FF) with a second sensor on nonoperated tissue improves distinction between systemic hypoperfusion and FF compromise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single\u2010institution, prospective study of patients undergoing head and neck FF reconstruction from December 2018 to April 2020. FFs were continuously monitored using NIRS on a monitor paddle with a second (control) sensor on the shoulder. Crude StO2 and percent change in StO2 were compared between the FF and control sensors on each patient, and percent change and percent difference between the control and the monitor paddle were documented to assess for congruity. Sentinel events (e.g., hypotension and hematoma) were documented to assess the association with change in StO2. These events and timing of StO2 changes were noted to assess associations with change in StO2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 48 patients had complete data. Donor sites included 35 soft\u2010tissue FFs and 13 fibula FFs. Average StO2 was 73.7\u2009\u00b1\u20095.5 for FFs and 71.4\u2009\u00b1\u20095.0 for control sensors. There were seven sentinel events during the study. At the time of the events, StO2 dropped significantly more for the FF than the control sensor (FF\u2009=\u200952.2% drop; control\u2009=\u20096.2% drop; <jats:italic>p<\/jats:italic>\u2009=\u2009.016). NIRS signal denoted change prior to changes in implantable arterial Doppler in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The addition of a second sensor when using NIRS as a primary modality for FF monitoring may improve distinction between FF compromise events and systemic hypoperfusion. By increasing accuracy of the monitor, there is a potential for decreased resident burden and decreased use of higher level of care nursing, which could reduce overall costs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.31142","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T18:13:22Z","timestamp":1708452802000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Second sensor to improve near\u2010infrared spectroscopy flap monitor utility: A prospective study"],"prefix":"10.1002","volume":"44","author":[{"given":"Jonathan","family":"Harper","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Slade","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrianne","family":"Cornette","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University Hospitals  Cleveland, OH United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra E.","family":"Kejner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head and Neck Surgery Medical University of South Carolina  Charleston South Carolina United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23325"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2016.03.007"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1345434"},{"key":"e_1_2_10_5_1","unstructured":"Fleming I. Giladi A. M. Means K. R. Jr. Colon A. F. &The Curtis National Hand CenterThe Use of Near\u2010Infrared Spectroscopy to Identify Digital Ischemia in Varying Skin Pigmentation Types. Poster presented 2020 AAHNS meeting.Baltimore MD."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2019.00050"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-974655"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181a47ce8"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2023.1130566"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PSN.0000000000000380"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2013.06.058"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22305"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25608"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20076"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008154"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102834"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-005-1655-0"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1296030"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.31142","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T09:04:52Z","timestamp":1710752692000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.31142"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,20]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/micr.31142"],"URL":"https:\/\/doi.org\/10.1002\/micr.31142","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,20]]},"assertion":[{"value":"2023-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e31142"}}