Use of laser speckle contrast imaging for successful fingertip replantation

Abstract

Fingertip replantation is a technical challenge for microsurgeons. For successful fingertip replantation, it is important to monitor the replanted fingertip vascularity for the early detection and revision of vascular compromise. Laser speckle contrast imaging (LSCI) is a camera-based technique that measures the perfusion by illuminating the tissue with a 785-nm-wavelength divergent laser beam. This creates a speckle pattern over the illuminated area. We present a case in which postoperative monitoring of the replanted fingertip microcirculation using LSCI allowed for successful Tamai zone I fingertip replantation. Postoperative monitoring using LSCI has 3 main advantages. First, this method is harmless to the patient and the replanted fingertip. A camera-based technique enables microcirculation monitoring without touching the patient or the replanted fingertip. Second, tissue perfusion is measured in real time and recorded continuously, allowing for the rapid response to the arterial or venous occlusion to be observed. Third, using LSCI, the skin perfusion can be measured quantitatively. Although further clinical investigations will be required to confirm its efficacy, LSCI has the potential to be a useful monitoring device.