COMPROMISED SURGICAL FLAP FOLLOWING EXCISION OF BASAL CELL CARCINOMA
Dr. Jonathan Arnold, MD
ABPM-UHM, CWS-P; Wound Care & Hyperbaric Medicine The Healing Center at Mercy Medical Center, Cedar Rapids, IA
CASE HISTORY
A 69-year-old male with right facial basal cell carcinoma was referred for care by an ENT surgeon following the excision of a cancerous lesion. Due to the size of the lesion, a large flap was required with concern regarding its tissue viability. Hyperbaric oxygen therapy (HBOT) was used as an advanced treatment modality to facilitate oxygen delivery to the flap and support wound healing. Tissue oxygenation imaging was captured using near-infrared spectroscopy (SnapshotNIR, Kent Imaging) before the initiation of treatment to document the baseline areas of flap compromise, and immediately following HBOT to document therapeutic benefit. SnapshotNIR imaging pre- and post-HBOT was repeated after 5 and 10 successive dives. The images captured at the time of the 10th HBO dive illustrated continued progress and helped to determine the completion of therapy.
OBSERVATIONS
Imaging obtained before and immediately following an HBOT session helped tailor the treatment to the minimum sessions required for optimal outcome. This approach aided in improving HBO use and cost containment. Documentation of progress using existing assessment therapies such as transcutaneous oxygen monitoring (TCOM) are very difficult, if not impossible, on this particular area of the body.
RESULTS
The near-infrared images obtained from SnapshotNIR provided objective information on what phase of healing the facial wound was in, the presence of infection, and the response to treatment. This helped reduce time to healing and associated costs to both the facility and patient, helping to enhance the patient’s quality of life.
“SnapshotNIR is quickly and easily administered. Compared to other tests, the amount of diagnostic information gained in a relatively short time is tremendous!”
Reference: Jonathan F. Arnold, MD, ABPM-UHM, CWS-P., et all. Interpretation of Near-Infrared Imaging in Acute and Chronic Wound Care – Diagnostics Journal
