Episode 25: Flap Monitoring in Breast Reconstruction and the History of the Guinea Pig Club in Plastic Surgery

Since having DIEP flap, a plastic reconstructive surgery technique performed to rebuild breasts after a mastectomy, I have been fascinated with the field of plastic surgery and topics related specifically to breast reconstruction.

I interview Rob Pupelis, CEO, of Spectros for the first episode of season three of the DiepCJourney podcast. Rob shares the story of his visit to the Queen Victory hospital (QVH) in England. He was able to visit Queen Victoria while attending the London Breast Meeting in late 2022. While at the conference, Rob demonstrated the T-Stat tissue oximetry system developed by Spectros. T-Stat is used to monitor flaps in breast reconstruction and in our conversation, we discuss the efficacy of the T-Stat system and why it improves the surgeon’s success rate of flap procedures like the DIEP flap.

We begin our conversation with the history of the Queen Victory Hospital treating burn victims during WWII. A surgeon from New Zealand, Archibald McIndoe, came to the Queen Victory hospital via a chance meeting with his cousin, Sir Harold Gillies, often considered the father of plastic surgery. Seeing the severe burn injuries sustained by pilots in WWII, McIndoe saw what his cousin, Sir Harold Gillies did using tube pedicles to rebuild the faces of WWI soldiers and expanded on this technique by treating the soldiers at Queen Victoria. He took healthy, unburnt tissue from other sites on the soldiers to reconstruct burnt tissue.

He nurtured this community, and these airmen were considered “guinea pigs” as part of his pioneering work in reconstructive burn surgery. These young airmen treated by Archibald McIndoe became known as the Guinea Pig club. He took them under his care not only during their physical healing but also treating the psychological impact of having disfigurement from these burns. There were over 600 of these airmen. Rob shared some of the photos hanging in the halls of QVH taken during his visit listing the members of The Guinea Pig Club, Archibald McIndoe, and the operating theater.

We go on to discuss modern day techniques used in microsurgery and how Rob became the CEO of Spectros. Flap monitoring is an important question many patients ask about. The T-Stat monitoring system is at the bedside of the patient after DIEP flap breast reconstruction to ensure that the blood flowing into the breast and out of the breast is monitored.

The physician performing the DIEP flap has 24-hour access to real time data provided by the monitoring system via a small sensor placed on the flap to monitor it while the patient is in hospital after surgery. We went on to discuss how T-Stat can be used regardless of the coloration of skin.

I hope this educational podcast discussion will encourage patients to ask about the type of tissue monitoring system their surgeon uses to monitor flaps during their initial consult for breast reconstruction. Many thanks to Rob for educating us about the benefits of the T-Stat system by Spectros.