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一种用于术后皮瓣监测的无线红外测温仪:在猪皮瓣模型中的概念验证。

A wireless infrared thermometry device for postoperative flap monitoring: Proof of concept in a porcine flap model.

机构信息

Department of Hand & Microsurgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, PR China.

Department of Gland Surgery, The Affiliated Nanhua Hospital, Hengyang Medical School, University of South China, Hengyang, PR China.

出版信息

Int Wound J. 2023 Aug;20(6):1839-1848. doi: 10.1111/iwj.14034. Epub 2022 Dec 19.

Abstract

The application of flap surgery is becoming more and more widespread with the development of microsurgical techniques. Currently, postoperative blood flow monitoring of flaps is still mainly assessed by medical staff for traditional clinical parameters, which has the disadvantage of being subjective and unable to monitor in real-time. This study describes a self-contained infrared wireless infrared thermometry device for flap blood supply monitoring and evaluates its effectiveness on eight porcine flap models. A scapular muscle flap model was established using eight small pigs, and the vessels were ligated at irregular intervals using a lumir ligature to simulate arterial crisis and venous crisis. Laser Doppler flowmetry (LDF), the wireless infrared thermometry device, and traditional clinical observation methods were applied to monitor the blood supply of the flap and evaluate the effect. The time to the determination of blood supply disturbance by wireless infrared thermography (IRT) was 28.75 ± 3.30 min and 96.5 ± 27.09 min for the arterial and venous groups, respectively; by LDF was 6.00 ± 1.41 min and 52.75 ± 15.76 min; by clinical observation was 42.00 ± 8.60 min and 156.50 ± 40.91 min, respectively. Paired t-tests were performed between the wireless IRT device and clinical observations, and the statistical results were significantly different in the arterial group and not significantly different in the venous group. Paired t-testing of the wireless infrared thermometry device with the LDF also showed significant differences in the arterial group and non-significant differences in the venous group. This wireless infrared thermometry device outperforms traditional clinical observation methods in monitoring blood supply in a porcine skin flap model. Because of its low cost, real-time monitoring, simple operation, and non-invasive features, it has the potential to be used in clinical practice as a routine means of postoperative blood supply monitoring in flap surgery.

摘要

随着显微外科技术的发展,皮瓣手术的应用越来越广泛。目前,皮瓣术后血流监测主要还是依靠医务人员评估传统的临床参数,这种方法存在主观性且无法实时监测的缺点。本研究介绍了一种用于皮瓣血供监测的自含式无线红外测温仪,并在 8 个猪皮瓣模型中评估了其有效性。使用 8 头小猪建立肩胛肌皮瓣模型,使用 lumir 结扎线不规则间隔结扎血管以模拟动脉危象和静脉危象。应用激光多普勒血流仪(LDF)、无线红外测温仪和传统临床观察方法监测皮瓣血供,并进行评估。无线红外热成像(IRT)确定供血障碍的时间分别为动脉组 28.75±3.30 分钟和静脉组 96.5±27.09 分钟;LDF 为 6.00±1.41 分钟和 52.75±15.76 分钟;临床观察为 42.00±8.60 分钟和 156.50±40.91 分钟。对无线 IRT 设备与临床观察进行配对 t 检验,动脉组的统计结果有显著差异,静脉组无显著差异。无线红外测温仪与 LDF 的配对 t 检验在动脉组也有显著差异,在静脉组无显著差异。与传统临床观察方法相比,该无线红外测温仪在监测猪皮瓣模型的血供方面表现更好。由于其成本低、实时监测、操作简单、非侵入性等特点,它有可能成为皮瓣手术后常规监测血供的一种手段,应用于临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fdb/10332992/b8398e4f475e/IWJ-20-1839-g003.jpg

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