Extended-wavelength diffuse reflectance spectroscopy for a comprehensive view of blood perfusion and tissue response in human forearm skin.

Background: The aim of this study was to investigate the possibility of using extended-wavelength diffuse reflectance spectroscopy (EW-DRS) to measure tissue response related to blood perfusion. The study was performed on a model that we have previously found to be useful for studying techniques for perfusion monitoring following the injection of epinephrine in a local anesthetic in the human forearm.

Methods: Nine healthy subjects were included in the study. Spectroscopy was performed with an EW-DRS system using a combination of two spectrometers to resolve light in the visible (350 nm to 1100 nm) and the near-infrared regions (900 nm to 1700 nm). The change in signal upon the injection of lidocaine (20 mg/ml) + epinephrine (12.5 μg/ml) (LIDO +EPI), compared to a control injection with saline (9 mg/ml), was investigated.

Results: Injection of lidocaine + epinephrine (12.5 μg/ml) caused a change in the EW-DRS signal in the wavelength intervals 510 to 610 nm, known to change upon deoxygenation of hemoglobin. When examining the full wavelength range (450 to 1550 nm) a decrease in reflectance upon LIDO +EPI injection was observed, suggesting that the broader spectrum provides more detailed information on the tissue response. The time to stable hypoperfusion was found to be 2.6 min.

Conclusions: EW-DRS appears to be a promising technique for monitoring perfusion, and could provide a useful tool in plastic and reconstructive surgery. The broad spectrum provides detailed information on the molecular changes taking place in the tissue. However, the technique must be thoroughly validated before it can be implemented in clinical practice.