Evaluation der Gewebeperfusion des mikrozirkulären Systems mit Hilfe von hyperspektraler Bildgebung nach Majoramputation an der unteren Extremität

by Charlotte Brinkmeyer
Doctoral thesis
Date of Examination:2023-09-19
Date of issue:2023-09-11
Advisor:Dr. Jennifer Ernst
Referee:Prof. Dr Arndt Schilling
Referee:Prof. Dr. Frauke Alves
Persistent Address: http://dx.doi.org/10.53846/goediss-10087

 

 

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Abstract

English

Introduction: Perfusion disorders are a frequent complication after major amputation at the lower limb. The resulting decreased tissue perfusion and venous stasis lead to wound healing disorders and tissue necrosis as well as reduced walking distance and pain at the residual limb. These are important determinants of health-related quality of life for the amputee. In this study it was hypothesized that differences in microcirculatory parameters between the sound limb (SL) and the residual limb (RL) could be revealed by hyperspectral imaging. Further the influence of physical activity and stress on those parameters was investigated. Methods: The study was approved by the local ethics committee. Ten subjects with major lower limb amputations were included in the study after giving informed consent. Defined locations at the SL and RL were measured at rest and after physical activity. Tissue oxygenation (StO2), near infrared (NIR) perfusion index, tissue hemoglobin index (THI) and tissue water index (TWI) were recorded. The parameters were imaged and measured with a hyperspectral camera (TIVITA® Diaspective Vision, Germany). Results: At rest, the RL showed at the amputation level a significantly higher oxygenation than the SL. After physical exercise, we recorded an absolute lower oxygenation at the RL compared to the SL. Furtheremore we recorded a significantly higher TWI at the RL compared to the SL. Conclusion: Differences of microcirculation between SL and RL can be detected by hyperspectral imaging at rest and after physical exercise. These data suggest that it may be possible to monitor the microcirculation in amputees by non-invasive hyperspectral imaging. Acknowledgement: Thanks to Dr. Axel Kulcke and the Diaspective Vision Team for providing the camera, Dr. Takashi Yoshida and Thomas Borchardt for the support of the research.
Keywords: major limb amputation; hyperspectral imaging; microcirculation; perfusion disorder
 
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