Method for assessing the viability boundaries of a DIEP flap using near-infrared spectroscopy in breast reconstruction
https://doi.org/10.17238/2072-3180-2026-2-144-150
Abstract
Introduction. Breast reconstruction using a DIEP flap is associated with a risk of ischemic complications, requiring objective intraoperative perfusion control. Existing monitoring methods are either subjective or aimed at the postoperative period.
The purpose of this study. To develop and evaluate the effectiveness of a method for intraoperative determination of the viability boundaries of a DIEP flap using near-infrared spectroscopy (INVOS).
Materials and methods. A prospective study included 28 patients who underwent breast reconstruction with a DIEP flap. Intraoperatively, using the INVOS 5100C system, regional oxygen saturation (rSO₂) was measured in four zones of the flap before pedicle division (target values), as well as after reperfusion. A viability criterion was an rSO₂ value of ≥60 %. Areas with values below 60 % were resected.
Research results and discussion. The mean rSO₂ values in zones I and II after reperfusion were 78,5±6,2 % and 72,1±8,4 %, respectively, which did not significantly differ from the target values. In zones III and IV, a decrease in rSO₂ below 60 % was observed in 11 (39,3 %) patients, requiring economical resection of the distal flap parts. The incidence of marginal necrosis in the postoperative period was 3,6 % (1 case).
Conclusion. The use of INVOS spectroscopy with a threshold rSO₂ value of 60 % allows for an objective and non-invasive determination of the viable part of a DIEP flap intraoperatively, minimizing the risk of ischemic complications.
About the Authors
N. G. Stepaniants
State Research Center – Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia; Medical Biological University of Innovations and Continuing Education, State Research Center – Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia
Russian Federation
Russian Federation
Nikolay G. Stepanyants – Cand. Sci. (Med.), Head of the Department of Surgical Oncology, Burnazyan Federal Medical Biophysical Center; Associate Professor, Department of Oncology and Radiation Medicine, Medical and Biological University of Innovation and Continuing Education, Burnazyan Federal Medical Biophysical Center.
123098, Moscow
M. Sh. Zugumova
State Research Center – Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia; Medical Biological University of Innovations and Continuing Education, State Research Center – Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia
Russian Federation
Russian Federation
Mariam Sh. Zugumova – Oncologist, Department of Surgical Oncology, Burnazyan Federal Medical Biophysical Center; Assistant, Department of Oncology and Radiation Medicine, Medical and Biological University of Innovation and Continuing Education, Burnazyan Federal Medical Biophysical Center.
123098, Moscow
S. E. Voskanyan
State Research Center – Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia; Medical Biological University of Innovations and Continuing Education, State Research Center – Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia
Russian Federation
Russian Federation
Sergey E. Voskanyan – Corresponding Member of the Russian Academy of Sciences, Dr. Sci. (Med.), Deputy Chief Physician for Surgical Care, Head of the Center for Surgery and Transplantology, Burnazyan Federal Medical Biophysical Center; Head of the Department of Surgery with Courses in Surgical Oncology, Endoscopy, Surgical Pathology, Clinical Transplantology and Organ Donation, Medical and Biological University of Innovation and Continuing Education, Burnazyan Federal Medical Biophysical Center.
123098, Moscow
K. A. Popugaev
Medical Biological University of Innovations and Continuing Education, State Research Center – Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia; Federal State Budgetary Institution "National Medical Research Center of Surgery named after A.V. Vishnevsky" of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Konstantin A. Popugayev – Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Anesthesiology and Intensive Care Department with Intensive Care Units, Vishnevsky National Medical Research Center of Surgery; Head of the Anesthesiology and Intensive Care Department, Burnazyan Federal Medical Biophysical Center.
123098, Moscow
K. O. Prazdnikov
State Research Center – Burnasyan Federal Medical Biophysical Center, Federal Medical Biological Agency of Russia
Russian Federation
Russian Federation
Kim O. Prazdnikov – Anesthesiologist-Intensivist, Anesthesiology and Intensive Care Department No. 1, Burnazyan Federal Medical Biophysical Center.
123098, Moscow
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Review
For citations:
Stepaniants N.G., Zugumova M.Sh., Voskanyan S.E., Popugaev K.A., Prazdnikov K.O. Method for assessing the viability boundaries of a DIEP flap using near-infrared spectroscopy in breast reconstruction. Moscow Surgical Journal. 2026;(2):144-150. (In Russ.) https://doi.org/10.17238/2072-3180-2026-2-144-150
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