Maxillofacial surgery

Why? (The Short Story)

Post-operative care for skin transplants is currently intensively qualitative. Our motivation is to research and develop a low-cost and easy-to-use device capable of quantitatively assessing blood perfusion to completely remove the possibility of flap failures.

The Long(er) Story

This research is a truly interdisciplinary and collaborative approach to investigate and quantify blood perfusion. It brings together optical physics, biophotonics, nanofabrication, microfluidics and data analysis.

Maxillofacial surgery has long included approaches to correcting damage to the skin in the head and neck region. These damages could be due to accidents or surgical treatments such as tracheotomies, which require surgical removal of tumours from the region. Consequently, tissue from other regions of the body is excised and moved to the region, post-surgery. Once completed, the patient is moved to critical post-operative care wherein the transplanted tissue is monitored.

Currently, the monitoring techniques use a flap monitoring chart that is used to assess various factors such as:

  • Colour
  • Temperature to touch
  • Capillary refill
  • Texture
  • Doppler sound (if a probe is present)
  • Light source (for reference if natural light, ward lights or a torchlight was used)

Flap failure can be rectified surgically if observed early and the surgical staff are alerted. While the above references are effective, they are extremely qualitative and subject to interpretation. To assist medical personnel, our research investigates markers to observe flaps and quantify their performance/failure using optical technologies and attempting to reduce the failure to a minimal rate.

This project is made possible by contributions from the British Association of Oral and Maxillofacial Surgeons (BAOMS) and is in collaboration with Mr Richard Pilkington (Oral and Maxillofacial Surgery, Cumberland Royal Infirmary, Carlisle) and Mr Mark Main. The research builds on previous research investigating blood diagnostics remotely through simulated, Monte Carlo methods.

Relevant Publications and Datasets

Main M. and Kallepalli A., Towards Point-of-Care Diagnostics and Monitoring of Hypertensive Episodes (a Monte Carlo Approach), Optica Biophotonics Congress: Optics in Life Sciences, Vancouver (23-27 April 2023)

Main, M., Pilkington J. J. R., Gibson G. M., Kallepalli A. (2022): Assessing variable degrees of blood perfusion in ischaemic skin flaps and grafts; Presented at Photon 2022 (Nottingham, UK)

Main M., Pilkington R. J. J., Gibson G. M., Kallepalli A. Simulated assessment of light transport through ischaemic skin flaps. British Journal of Oral and Maxillofacial Surgery (2022); DOI: 10.1016/j.bjoms.2022.03.004
ScienceDirect Access

Kallepalli A. and James D. B., Quantification and influence of skin chromophores for remote detection of anemic conditions. Proc. SPIE 11238, Optical Interactions with Tissue and Cells XXXI, 112381B (20 February 2020); DOI: 10.1117/12.2545784

Main M., Pilkington R. J. J., Gibson G. M., Kallepalli A. (2022): Simulated Assessment of light transport through ischaemic skin flaps. University of Glasgow. DOI: 10.5525/gla.researchdata.1247

Kallepalli A. and James D. B. (2020): Monte Carlo simulation results for anaemia detection in the skin. Cranfield Online Research Data (CORD). DOI: 10.17862/cranfield.rd.11317187.v2

Kallepalli A., James D. B., Richardson M. A. (2021): Monte Carlo simulation results for full finger models based on ultrasound image data. Cranfield Online Research Data (CORD). DOI: 10.17862/cranfield.rd.11603883.v2