Browsing by Author "Neaves, Kevin Mark"
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- ItemDesign and development of a device to aid in tissue flap monitoring(Stellenbosch : Stellenbosch University, 2016-03) Neaves, Kevin Mark; Muller, Jacobus Hendrik; Van den Heever, David Jacobus; Stellenbosch University. Faculty of Engineering. Dept. of Mechanical and Mechatronic Engineering.ENGLISH ABSTRACT: Tissue flaps form an important part of plastic and reconstructive surgery. They are transferred with their own blood supply and are typically applied to wounds where skin grafts are unsuitable. Monitoring of tissue flaps is an important practice as it can assist in determining flap condition and the detection of circulatory complications. Detecting complications timeously is beneficial if the flap is to be salvaged. In the case of pedicled groin flaps, a technique known as ischemic preconditioning (IP) has proven to be beneficial in promoting early flap separation. A literature survey revealed that IP has only been manually implemented and an automated procedure would benefit patient and staff, particularly in a South African public hospital setting. A device was designed and developed which makes use of pulse oximetry to assist in tissue flap monitoring and analyses of current IP protocols. The device is capable of monitoring and recording information including the oxygen saturation (SpO2) and photoplethysmogram (PPG) measured from three different sites. In addition to this, the device automated the IP process by controlling the inflation of a pneumatic tourniquet. Several device tests were performed prior to clinical trials, including functionality tests which indicated that the device is capable of measurements on those areas of the body that are relevant to tissue flaps. Tests indicated that the device should not be limited to the monitoring of a single tissue flap type. The completed device was delivered to a plastic and reconstructive surgeon who carried out the clinical trials at Chris Hani Baragwanath Hospital. Clinical testing was performed on four subjects who underwent pedicled groin flap surgery. Reasonable signal quality was obtained from the last three cases. Errors and shortcomings from the first case were addressed and corrected where possible. Analysis of the recorded data coincided with standard clinical observations, indicating that the device was able to assist determining flap condition. Two of the three patients undergoing IP benefited from early flap division. Additional clinical tests could further prove the function and efficacy of the device, as well as improving post-testing data analysis methods.