Applicational efficacy of infrared thermal imager in monitoring postoperative blood supply of flap_West China Medical Journal

Authors：

SUN Yani , ZHENG Xianyou , HE Dan , QIAN Huijuan , LI Difei ,  HU Sanlian

Department of Orthopedics, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200233, P. R. China;

Corresponding author：

HU Sanlian, Email: Liuliu9027@163.com

Keywords：

Infrared thermal imager; skin-contact thermometer; flap surgery; blood flow monitoring; vascular crisis

DOI：

10.7507/1002-0179.202207162

Video：

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Objective To explore the clinical application and effect of infrared thermal imager in blood flow monitoring after skin flap surgery by comparing with skin-contact thermometer. Methods Fifty patients who had undergone flap repair in the microsurgery ward of Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between October 2019 and October 2020 were enrolled. An infrared thermal imager (FLIR ONE Pro) and a skin-contact thermometer were applied to monitor the skin temperature change till 7 d after surgery. The time consumed of using infrared thermal imager and skin-contact thermometer by different nurses, the efficacy of flap temperature monitoring of the two devices, the temperatures at different time points by using the two devices, and the temperatures under different distances to the flaps by using infrared thermal imager were compared. Results Different nurses had no difference in operating either of the two devices (P>0.05). It took significantly less time to measure the temperature of the flap area with the infrared thermal imager than using skin-contact thermometer [(39.28±3.52) vs. (103.85±9.09) s, P<0.001]. The skin temperature measured by the infrared thermal imager was significantly higher than that by the skin-contact thermometer (P<0.001), and the skin temperature measured by the infrared thermal imager at a height of 30 cm was higher than that at a height of 50 cm (P=0.006), but the temperature change amplitudes were both stable. Conclusions Infrared thermal imager is superior to skin-contact thermometer in terms of temperature measurement time, ease of operation, and sensitivity to temperature changes after skin flap operations. The thermal image collected by infrared thermal imager can provide an important basis for the identification of flap vascular crisis. It is a visual and objective blood supply monitoring equipment.

Citation： SUN Yani, ZHENG Xianyou, HE Dan, QIAN Huijuan, LI Difei, HU Sanlian. Applicational efficacy of infrared thermal imager in monitoring postoperative blood supply of flap. West China Medical Journal, 2022, 37(12): 1812-1817. doi: 10.7507/1002-0179.202207162 Copy

1.	Lohman RF, Ozturk CN, Ozturk C, et al. An analysis of current techniques used for intraoperative flap evaluation. Ann Plast Surg, 2015, 75(6): 679-685.
2.	赵彩英, 刘杰永, 乔建华, 等. 腹部带蒂皮瓣修复手部创面的护理. 华西医学, 2010, 25(5): 1003-1004.
3.	梁妮, 李伟霞. 红外线热成像在游离皮瓣移植术后皮瓣血液循环监测中的应用进展. 中西医结合护理(中英文), 2018, 4(10): 214-217.
4.	许鑫, 宋秋燕, 王凤岩, 等. 不同皮温检测方法在穿支皮瓣移植术后护理中的应用. 解放军护理杂志, 2011, 28(9): 12-14.
5.	Salmi AM, Tukiainen E, Asko-Seljavaara S. Thermographic mapping of perforators and skin blood flow in the free transverse rectus abdominis musculocutaneous flap. Ann Plast Surg, 1995, 35(2): 159-164.
6.	李寿鹏, 续琴, 冯燕, 等. 红外线热成像仪评价组织坏死期血栓闭塞性脉管炎的治疗效果. 血管与腔内血管外科杂志, 2018, 4(6): 490-495.
7.	郑雪红, 王秀丽, 赵燕丹, 等. 红外线热成像仪皮温监测在组织移植再植术后护理中的应用. 中华显微外科杂志, 2021, 44(4): 468-470.
8.	刘丽娟. 医用红外线热成像技术的物理学原理探析. 科技展望, 2016(5): 158.
9.	郑宏庭, 陈卫, 邓华聪. 应用红外热像技术评估糖尿病合并下肢血管病变患者治疗效果与预后. 中国临床康复, 2004(6): 1176-1177.
10.	Romanò CL, Romanò D, Dell’Oro F, et al. Healing of surgical site after total hip and knee replacements show similar telethermographic patterns. J Orthop Traumatol, 2011, 12(2): 81-86.
11.	张旭东, 缪建良, 姚卫华, 等. 远红外线热成像图在观察随意皮瓣活性中的应用研究. 中国美容医学, 2014, 23(18): 1526-1530.
12.	黄天翔, 潘佳栋, 肖栋超, 等. 红外热成像术在术中皮瓣血供评估中的应用进展. 骨科临床与研究杂志, 2021, 6(3): 180-183.
13.	Engel H, Huang JJ, Tsao CK, et al. Remote real-time monitoring of free flaps via smartphone photography and 3G wireless Internet: a prospective study evidencing diagnostic accuracy. Microsurgery, 2011, 31(8): 589-595.
14.	徐伟华, 林平, 许甜甜, 等. 红外线热成像技术在游离股前外侧穿支皮瓣设计中的应用. 中国骨伤, 2019, 32(11): 1053-1057.
15.	付琼, 彭伶丽. 皮瓣移植术后血管危象发生的影响因素分析. 全科医学, 2020, 18(15): 1843-1845.
16.	Markiewicz MR, Bell RB, Bui TG, et al. Survival of microvascular free flaps in mandibular reconstruction: a systematic review and meta-analysis. Microsurgery, 2015, 35(7): 576-587.
17.	Ishimaru M, Ono S, Suzuki S, et al. Risk factors for free flap failure in 2846 patients with head and neck cancer: a national database study in Japan. J Oral Maxillofac Surg, 2016, 74: 1265-1270.
18.	Bui DT, Cordeiro PG, Hu QY, et al. Free flap reexploration: indications, treatment, and outcomes in 1193 free flaps. Plast Reconstr Surg, 2007, 119(7): 2092-2100.
19.	熊哲祯, 许律廷, 刘凯. 红外线成像技术在皮瓣移植围手术期检测中的应用. 组织工程与重建外科杂志, 2018, 14(6): 331-334.
20.	施平, 袁萍, 盛誉, 等. 红外线皮温仪监测断指再植术后血管危象的预警效果. 南通大学学报(医学版), 2020, 40(4): 348-357.

1. Lohman RF, Ozturk CN, Ozturk C, et al. An analysis of current techniques used for intraoperative flap evaluation. Ann Plast Surg, 2015, 75(6): 679-685.
2. 赵彩英, 刘杰永, 乔建华, 等. 腹部带蒂皮瓣修复手部创面的护理. 华西医学, 2010, 25(5): 1003-1004.
3. 梁妮, 李伟霞. 红外线热成像在游离皮瓣移植术后皮瓣血液循环监测中的应用进展. 中西医结合护理(中英文), 2018, 4(10): 214-217.
4. 许鑫, 宋秋燕, 王凤岩, 等. 不同皮温检测方法在穿支皮瓣移植术后护理中的应用. 解放军护理杂志, 2011, 28(9): 12-14.
5. Salmi AM, Tukiainen E, Asko-Seljavaara S. Thermographic mapping of perforators and skin blood flow in the free transverse rectus abdominis musculocutaneous flap. Ann Plast Surg, 1995, 35(2): 159-164.
6. 李寿鹏, 续琴, 冯燕, 等. 红外线热成像仪评价组织坏死期血栓闭塞性脉管炎的治疗效果. 血管与腔内血管外科杂志, 2018, 4(6): 490-495.
7. 郑雪红, 王秀丽, 赵燕丹, 等. 红外线热成像仪皮温监测在组织移植再植术后护理中的应用. 中华显微外科杂志, 2021, 44(4): 468-470.
8. 刘丽娟. 医用红外线热成像技术的物理学原理探析. 科技展望, 2016(5): 158.
9. 郑宏庭, 陈卫, 邓华聪. 应用红外热像技术评估糖尿病合并下肢血管病变患者治疗效果与预后. 中国临床康复, 2004(6): 1176-1177.
10. Romanò CL, Romanò D, Dell’Oro F, et al. Healing of surgical site after total hip and knee replacements show similar telethermographic patterns. J Orthop Traumatol, 2011, 12(2): 81-86.
11. 张旭东, 缪建良, 姚卫华, 等. 远红外线热成像图在观察随意皮瓣活性中的应用研究. 中国美容医学, 2014, 23(18): 1526-1530.
12. 黄天翔, 潘佳栋, 肖栋超, 等. 红外热成像术在术中皮瓣血供评估中的应用进展. 骨科临床与研究杂志, 2021, 6(3): 180-183.
13. Engel H, Huang JJ, Tsao CK, et al. Remote real-time monitoring of free flaps via smartphone photography and 3G wireless Internet: a prospective study evidencing diagnostic accuracy. Microsurgery, 2011, 31(8): 589-595.
14. 徐伟华, 林平, 许甜甜, 等. 红外线热成像技术在游离股前外侧穿支皮瓣设计中的应用. 中国骨伤, 2019, 32(11): 1053-1057.
15. 付琼, 彭伶丽. 皮瓣移植术后血管危象发生的影响因素分析. 全科医学, 2020, 18(15): 1843-1845.
16. Markiewicz MR, Bell RB, Bui TG, et al. Survival of microvascular free flaps in mandibular reconstruction: a systematic review and meta-analysis. Microsurgery, 2015, 35(7): 576-587.
17. Ishimaru M, Ono S, Suzuki S, et al. Risk factors for free flap failure in 2846 patients with head and neck cancer: a national database study in Japan. J Oral Maxillofac Surg, 2016, 74: 1265-1270.
18. Bui DT, Cordeiro PG, Hu QY, et al. Free flap reexploration: indications, treatment, and outcomes in 1193 free flaps. Plast Reconstr Surg, 2007, 119(7): 2092-2100.
19. 熊哲祯, 许律廷, 刘凯. 红外线成像技术在皮瓣移植围手术期检测中的应用. 组织工程与重建外科杂志, 2018, 14(6): 331-334.
20. 施平, 袁萍, 盛誉, 等. 红外线皮温仪监测断指再植术后血管危象的预警效果. 南通大学学报(医学版), 2020, 40(4): 348-357.

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