Post-Operative Monitoring of Intestinal Tissue Oxygenation Using an Implantable Microfabricated Oxygen Sensor

Anastomotic leakage (AL) is a common and dangerous post-operative complication following intestinal resection, causing substantial morbidity and mortality. Ischaemia in the tissue surrounding the anastomosis is a major risk-factor for AL development. Continuous tissue oxygenation monitoring during t...

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Published inMicromachines (Basel) Vol. 12; no. 7; p. 810
Main Authors Marland, Jamie R K, Gray, Mark E, Argyle, David J, Underwood, Ian, Murray, Alan F, Potter, Mark A
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 10.07.2021
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Abstract Anastomotic leakage (AL) is a common and dangerous post-operative complication following intestinal resection, causing substantial morbidity and mortality. Ischaemia in the tissue surrounding the anastomosis is a major risk-factor for AL development. Continuous tissue oxygenation monitoring during the post-operative recovery period would provide early and accurate early identification of AL risk. We describe the construction and testing of a miniature implantable electrochemical oxygen sensor that addresses this need. It consisted of an array of platinum microelectrodes, microfabricated on a silicon substrate, with a poly(2-hydroxyethyl methacrylate) hydrogel membrane to protect the sensor surface. The sensor was encapsulated in a biocompatible package with a wired connection to external instrumentation. It gave a sensitive and highly linear response to variations in oxygen partial pressure in vitro, although over time its sensitivity was partially decreased by protein biofouling. Using a pre-clinical in vivo pig model, acute intestinal ischaemia was robustly and accurately detected by the sensor. Graded changes in tissue oxygenation were also measurable, with relative differences detected more accurately than absolute differences. Finally, we demonstrated its suitability for continuous monitoring of tissue oxygenation at a colorectal anastomosis over a period of at least 45 h. This study provides evidence to support the development and use of implantable electrochemical oxygen sensors for post-operative monitoring of anastomosis oxygenation.
AbstractList Anastomotic leakage (AL) is a common and dangerous post-operative complication following intestinal resection, causing substantial morbidity and mortality. Ischaemia in the tissue surrounding the anastomosis is a major risk-factor for AL development. Continuous tissue oxygenation monitoring during the post-operative recovery period would provide early and accurate early identification of AL risk. We describe the construction and testing of a miniature implantable electrochemical oxygen sensor that addresses this need. It consisted of an array of platinum microelectrodes, microfabricated on a silicon substrate, with a poly(2-hydroxyethyl methacrylate) hydrogel membrane to protect the sensor surface. The sensor was encapsulated in a biocompatible package with a wired connection to external instrumentation. It gave a sensitive and highly linear response to variations in oxygen partial pressure in vitro, although over time its sensitivity was partially decreased by protein biofouling. Using a pre-clinical in vivo pig model, acute intestinal ischaemia was robustly and accurately detected by the sensor. Graded changes in tissue oxygenation were also measurable, with relative differences detected more accurately than absolute differences. Finally, we demonstrated its suitability for continuous monitoring of tissue oxygenation at a colorectal anastomosis over a period of at least 45 h. This study provides evidence to support the development and use of implantable electrochemical oxygen sensors for post-operative monitoring of anastomosis oxygenation.
Author Potter, Mark A
Marland, Jamie R K
Argyle, David J
Gray, Mark E
Murray, Alan F
Underwood, Ian
AuthorAffiliation 3 School of Engineering, Institute for Bioengineering, University of Edinburgh, Faraday Building, Edinburgh EH9 3DW, UK; alan.murray@ed.ac.uk
4 Department of Surgery, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK; mark.potter@ed.ac.uk
1 School of Engineering, Institute for Integrated Micro and Nano Systems, University of Edinburgh, Scottish Microelectronics Centre, King’s Buildings, Edinburgh EH9 3FF, UK; ian.underwood@ed.ac.uk
2 The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Easter Bush, Roslin, Midlothian EH25 9RG, UK; mark.gray@ed.ac.uk (M.E.G.); david.argyle@roslin.ed.ac.uk (D.J.A.)
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Issue 7
Keywords electrochemical
oxygen sensor
oxygenation
microfabricated
anastomotic leakage
Language English
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  article-title: Tissue oxygen tension as a predictor of colonic anastomotic healing
  publication-title: Dis. Colon Rectum
  doi: 10.1007/BF02555426
  contributor:
    fullname: Sheridan
– volume: 26
  start-page: 131
  year: 2006
  ident: ref_7
  article-title: Clinical review: Healing in gastrointestinal anastomoses, Part I
  publication-title: Microsurgery
  doi: 10.1002/micr.20197
  contributor:
    fullname: Thompson
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Snippet Anastomotic leakage (AL) is a common and dangerous post-operative complication following intestinal resection, causing substantial morbidity and mortality....
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SubjectTerms Adhesives
anastomotic leakage
Biocompatibility
Biofouling
Bond strength
Chemical sensors
electrochemical
Electrodes
Electrolytes
Hemoglobin
Hydrogels
In vivo methods and tests
Life sciences
Microelectrodes
microfabricated
Monitoring
Oxygen probes
Oxygen saturation
oxygen sensor
Oxygenation
Partial pressure
Patients
Polyhydroxyethyl methacrylate
Risk analysis
Sensor arrays
Sensors
Silica
Silicon substrates
Silicon wafers
Spectrum analysis
Surgical anastomosis
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Title Post-Operative Monitoring of Intestinal Tissue Oxygenation Using an Implantable Microfabricated Oxygen Sensor
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