Walle Leonard, Fansa Hisham, Frerichs Onno
Klinikum Bielefeld Mitte, Klinik für Plastische, Rekonstruktive und Ästhetische Chirurgie - Handchirurgie.
Handchir Mikrochir Plast Chir. 2018 Apr;50(2):111-117. doi: 10.1055/s-0043-114006. Epub 2018 Apr 19.
Thermography permits non-invasive examination and presentation of cutaneous temperature differences. When planning microvascular flaps, thermography may illustrate these differences and may portray patterns of blood circulation near to perforators. As an additional tool, thermography may enhance quality and diversity in free flaps.
In this prospective study, we examined 10 patients with 13 free DIEP-flaps for breast reconstruction. With smartphone-based thermography, we analysed preoperative abdominal "hot spots" of skin circulation (entrance of perforators). The results were compared with preoperative computed tomographic angiography (CTA) and intraoperative anatomical findings.
Thermography was succesfully performed on all patients. Areas of perfusion were reliably shown in the raised area ("hot spot"). Each perforator selected by thermography was also selected for the DIEP free flap on the basis of intraoperative findings. Moreover, the identified main perforators were identical to perforators found at the CTA.
Smartphone-based thermography provides an easy, rapid and non-invasive method to present cutaneous differences in temperature. "Hot spots" can reliably illustrate the entrance of perforators. When selecting a suitable perforator, thermography provides additional information for imaging perforator-based flaps.
热成像技术可进行无创检查并呈现皮肤温度差异。在规划微血管皮瓣时，热成像技术可显示这些差异，并描绘穿支附近的血液循环模式。作为一种辅助工具，热成像技术可提高游离皮瓣的质量和多样性。
在这项前瞻性研究中，我们检查了10例患者的13个用于乳房重建的游离腹壁下动脉穿支皮瓣（DIEP皮瓣）。通过基于智能手机的热成像技术，我们分析了术前腹部皮肤循环的“热点”（穿支入口）。将结果与术前计算机断层血管造影（CTA）及术中解剖结果进行比较。
所有患者均成功进行了热成像检查。灌注区域在隆起区域（“热点”）可靠显示。热成像技术选择的每个穿支在术中也被选用于游离DIEP皮瓣。此外，识别出的主要穿支与CTA检查发现的穿支一致。
基于智能手机的热成像技术提供了一种简单、快速且无创的方法来呈现皮肤温度差异。“热点”能够可靠地显示穿支入口。在选择合适的穿支时，热成像技术为基于穿支的皮瓣成像提供了额外信息。
