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用红外热成像预测腹壁成形术并发症:Δ-R分析

Predicting lipoabdominoplasty complications with infrared thermography: a delta-R analysis.

作者信息

Resende Patricia Rodrigues, Brioschi Marcos Leal, De Meneck Franciele, Neves Eduardo Borba, Teixeira Manoel Jacobsen

机构信息

Postgraduate Program in Thermology and Medical Thermography, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.

School of Medicine, Federal University of São Paulo, São Paulo, Brazil.

出版信息

Arch Plast Surg. 2021 Sep;48(5):553-558. doi: 10.5999/aps.2021.00101. Epub 2021 Sep 15.

Abstract

The diagnosis of the main complications resulting from lipoabdominoplasty has not yet been standardized. Infrared thermal imaging has been used to assess possible complications, such as necrosis and changes in micro- and macro-circulation, based on perforator mapping techniques, among others. The objective of this study was to present two clinical cases involving thermal imaging monitoring of the healing process of lipoabdominoplasty in the immediate postoperative evaluation and its preliminary results. Infrared thermography was performed 24 hours after the operation and on postoperative days 5, 25, and 27. In clinical case 1, it was found that the delta-R (∆TR)-defined as the difference in minimum temperature between the highest and lowest points in the SA3 region (caution suction area) following the classification established by Matarasso-was 0.4°C at 24 hours after surgery and decreased to 0.1°C on a postoperative day 5. There were no complications in this case. In contrast, in clinical case 2, the ∆TR was 1.7°C at 24 hours after surgery (upon hospital discharge) and remained high, at 2.2°C, on postoperative day 5. A higher ∆TR was found in the second patient, who developed necrosis of the surgical wound. The ∆TR thermal index may be a new tool for predicting possible complications, complementing the clinical evaluation and therapeutic decision-making.

摘要

腹部抽脂成形术主要并发症的诊断尚未标准化。红外热成像已被用于评估可能的并发症,比如基于穿支血管定位技术等评估坏死以及微循环和大循环的变化。本研究的目的是呈现两例临床病例,涉及在术后即刻评估中对腹部抽脂成形术愈合过程进行热成像监测及其初步结果。术后24小时以及术后第5、25和27天进行红外热成像检查。在临床病例1中,发现按照马塔拉索建立的分类,SA3区域(谨慎抽吸区域)最高点与最低点之间的最低温度差即δ-R(∆TR)在术后24小时为0.4°C,术后第5天降至0.1°C。该病例未出现并发症。相比之下,在临床病例2中,术后24小时(出院时)∆TR为1.7°C,术后第5天仍居高不下,为2.2°C。在出现手术伤口坏死的第二名患者中发现了更高的∆TR。∆TR热指数可能是预测可能并发症的一种新工具,可补充临床评估和治疗决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59c5/8490102/49756462e5f2/aps-2021-00101f1.jpg

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