Simulated assessment of light transport through ischaemic skin flaps

Main, M., Pilkington, R. J.J., Gibson, G. M. and Kallepalli, A. (2022) Simulated assessment of light transport through ischaemic skin flaps. British Journal of Oral and Maxillofacial Surgery, 60(7), pp. 969-973. (doi: 10.1016/j.bjoms.2022.03.004) (PMID:35568579)

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Currently, free flaps and pedicled flaps are assessed for reperfusion in post-operative care using colour, capillary refill, temperature, texture, and Doppler signal (if available). While these techniques are effective, they are prone to error due to their qualitative nature. In this research, different wavelengths of light are used to quantify the response of ischaemic tissue. The assessment provides indicators that are key to the goal of developing a point-of-care diagnostics device, capable of observing reduced perfusion quantitatively. Detailed optical models of the layers of the skin were set up and appropriate optical properties were assigned, with due consideration of melanin and haemoglobin concentrations. A total of 24 models of healthy, perfused tissue and perfusion-deprived tissue to assess the responses when illuminated with visible and near-infrared wavelengths of light. In addition to detailed fluence maps of photon propagation, a simple mathematical model is proposed to assess the differential propagation of photons in tissue; the optical reperfusion factor (ORF). The results show clear advantages of using light at longer wavelengths (red, near-infrared) and the inferences drawn from the simulations hold significant clinical relevance. The simulated scenarios and results consolidate the belief of a multi-wavelength, point-of-care diagnostics device and inform its design for quantifying blood flow in transplanted tissue. The modelling approach is applicable beyond the current research, wherein other medical conditions that can be mathematically represented in the skin can be investigated. Through these, additional inferences and approaches to other point-of-care devices can be realised.

Item Type:Articles
Additional Information:We wish to acknowledge the support from the Research Fund awarded by the Endowments Sub Committee of the British Association of Oral and Maxillofacial Surgeons (2021), EPSRC Research Council funding [EP/T517896/1, EP/M01326X/1] and the Royal Society. We would also like to thank Dr Qianqian Fang, Shijie Yan and Dr Yaoshen Yuan (Computational Optics and Translational Imaging Lab, College of Engineering, Northeastern University, Boston) for their invaluable advice and assistance with MCX, the Monte Carlo simulation platform used in this research.
Glasgow Author(s) Enlighten ID:Gibson, Dr Graham and Main, Mr Mark and Kallepalli, Dr Akhil
Authors: Main, M., Pilkington, R. J.J., Gibson, G. M., and Kallepalli, A.
College/School:College of Science and Engineering > School of Engineering
College of Science and Engineering > School of Physics and Astronomy
Journal Name:British Journal of Oral and Maxillofacial Surgery
ISSN (Online):1532-1940
Published Online:18 March 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in British Journal of Oral and Maxillofacial Surgery 60(7): 969-973
Publisher Policy:Reproduced under a Creative Commons License
Data DOI:10.5525/gla.researchdata.1247

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
312561EPSRC DTP 2020/21Christopher PearceEngineering and Physical Sciences Research Council (EPSRC)EP/T517896/1Research and Innovation Services
190841UK Quantum Technology Hub in Enhanced Quantum ImagingMiles PadgettEngineering and Physical Sciences Research Council (EPSRC)EP/M01326X/1P&S - Physics & Astronomy