Design of a system combining narrow band illuminants and a color camera for early diagnosis of skin flap necrosis

2021 
In plastic surgery, free tissue graft procedures are an essential part of fixing tissue-lack injuries or diseases. However, tissue necrosis caused by vascular occlusions or poor vascular anastomosis is a severe problem for prognosis. Follow-up surgery in the early-stage of necrosis caused by congestion or ischemia is essential to salvage the tissue, but making a diagnosis is difficult because of the slight features of these states. Therefore, a diagnosis support system that can capture the features of blood circulation of the skin flap is required to improve prognosis. We focused on system design and analysis by using spectral characteristics of blood circulation of a skin flap for this purpose. The system to be constructed is composed of a two-channel narrow-band illuminant and a color camera and can capture six-channel spectral signals. The narrow-band illuminant is designed by combining 13 kinds of light-emitting diode (LED) spectra. In this study, we first measured reflectance spectra of the early-stage skin flap necrosis of the rat model to design the narrow-band illuminant spectra. We blocked the flow of the target vessel and observed necrosis progression. A prototyped skin flap chamber was used for stable observation of spectral reflectance measurements. An evaluation experiment was conducted using a color camera and the spectrally tunable light source. Skin flap images were captured under the designedilluminants and a conventional illuminant reproduced by the spectrally tunable light source. We confirmed the effectiveness of the designed system by improvements in necrosis region detection.
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