Centre for Applied Health & Social Care Research, Health Research Institute, Sheffield Hallam University, Sheffield S10 2BP, UK.
Semiconductor Materials and Devices Research Group, Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield S10 2TN, UK.
Int J Environ Res Public Health. 2023 Mar 14;20(6):5100. doi: 10.3390/ijerph20065100.
Evidence has shown an association between obesity and an increased risk of wound infection after caesarean section. This study was designed to examine if abdominal subcutaneous adiposity impacts upon cutaneous perfusion dynamics.
Mild cool challenge, followed by real-time video thermography, was developed to map the appearance of abdominal 'hot spots'. Correspondence of marked 'spots' with audible Doppler and colour and power Doppler ultrasound was performed.
60 healthy, afebrile, women (20-68 years; BMI 18.5-44 kg/m) were recruited. Hot spot appearance consistently corresponded with audible Doppler sounds. Colour and power Doppler ultrasound revealed vessels at depths of 3-22 mm. No statistically significant interactions for BMI, abdominal circumference or environmental parameters were observed for hot spot count. The temperature of cold stimulus was significant for effects on spot count, but only for the first minute ( = 0.001). Thereafter, effects on spot numbers were not significant.
Cutaneous 'perforator' mapping of the abdomen (via hot spot appearance) in healthy women, as a potential and future method for risk of perfusion-dependent wound healing complications, reveals that bedside mapping of skin perfusion is feasible over a short interval. Hot spot number was not influenced by BMI or indicators of central fat distribution (abdominal circumference) indicating variability in an individual's vascular anatomy. This study provides the underpinning methodology for personalised perfusion assessment after incisional surgery which may be a more reliable indicator of potential healing complications than body habitus as is currently the norm.
有证据表明，肥胖与剖宫产术后伤口感染风险增加之间存在关联。本研究旨在探讨腹部皮下脂肪是否会影响皮肤灌注动力学。
采用轻度冷刺激，结合实时视频热成像技术，绘制腹部“热点”出现的图谱。对明显“热点”与可闻多普勒、彩色和能量多普勒超声的对应关系进行了研究。
共招募了 60 名健康、无发热的女性（20-68 岁；BMI 为 18.5-44kg/m²）。热点的出现始终与可闻多普勒声音相对应。彩色和能量多普勒超声显示血管深度为 3-22mm。热点计数与 BMI、腹围或环境参数之间没有观察到统计学显著的相互作用。冷刺激的温度对热点计数有显著影响，但仅在第一分钟（=0.001）。此后，对热点数量的影响不再显著。
对健康女性腹部皮肤（通过热点出现）进行“穿支”映射（作为一种潜在的、未来的与灌注相关的伤口愈合并发症风险的方法）表明，在短时间内对皮肤灌注进行床边映射是可行的。BMI 或中央脂肪分布指标（腹围）对热点数量没有影响，这表明个体血管解剖结构存在差异。本研究为切口手术后的个性化灌注评估提供了基础方法，这可能是比目前常规的体型更可靠的潜在愈合并发症的指标。
