Perfusion Analysis by Laser Speckle Predicts the Extent of Skin Graft Necrosis.
Intraoperative graft bed perfusion strongly correlates with extent of skin graft necrosis
Perfusion Analysis by Laser Speckle Predicts the Extent of Skin Graft Necrosis.
Skin graft necrosis is a common complication in dermatologic surgery, but reliable methods for predicting its occurrence are lacking.
We aimed to analyze the relationship between perfusion, assessed intraoperatively or postoperatively with laser speckle contrast imaging, and the extent of necrosis on day 28.
Fifty-five adults undergoing skin grafting after skin cancer excision were included.
Significant linear regression models showed that intraoperative graft bed perfusion and day 7 graft perfusion explained 75% and 46% of the variability in necrosis extent, respectively.
Overall, each unit increase in graft bed perfusion reduced necrosis extent by 41 percentage points, whereas each unit increase in day 7 graft perfusion reduced necrosis extent by 21 percentage points.
The perfusion threshold with the highest predictive value for clinically significant necrosis was identified in the graft bed.
Laser speckle contrast imaging may provide valuable information as a predictive tool for necrosis through rapid, noninvasive perfusion analysis, allowing the identification of patients who are optimal candidates for skin grafting and those who may require prolonged wound care.