The use of thermography to design tissue flaps - experimental studies on animals.

Abstract

IntroductionMethods allowing one to locate the position of a cutaneous perforator do not allow one to determine the boundaries of the vascularized skin. In clinical practice this causes complications in the form of marginal necrosis of the flap.AimTo examine the usefulness of thermography to assess the extent of vascularization of the skin and subcutaneous tissue by a single perforator.Material and methodsThirty-one male rats were used. Using dynamic thermography the perforators on the abdominal skin were located. Afterwards the flap was prepared on a randomly chosen perforator. After 24 h the extent of vascularization of the skin by a single perforator was examined.ResultsIn 22.5% of cases the number of perforators marked in the thermography was equal to the number of perforators marked intraoperatively, in 64.5% it was lower and in 13% higher. The use of thermography has shown that basing the flap vascularization on the perforator with low efficiency resulted in statistically more frequent occurrence of ischemia and partial necrosis of the flap (p = 0.024). Partial necrosis of the flap occurred in 12 of 31 cases, always in the area in which during the preoperative thermography no perforators were found. The areas of necrosis occurred irrespectively of the distance from the supplying vessel.ConclusionsWhen designing the shape of the flap, the distribution of all perforators must be considered. The perforators need to be included in the area of prepared tissues because their location indicates the area with a more efficient network of vessels.

Clinical usefulness of infrared thermography to detect sick animals: frequent and current cases

“…A review by John et al [83] reported that IRT can identify hyperthermic events and indicate the loss of local circulation (ischemia), so it can serve as an indicator in the field of reconstructive plastic surgery by distinguishing viable from non-viable tissues. For example, Czapla et al [84], used 31 rats as models for skin tissue flaps. IRT analysis showed that the flaps' frequency of ischemia and partial necrosis showed significant differences (P = 0.024) that were attributed to changes in dermal circulatory patterns.…”

Experimental and Clinical Study of Flap Monitoring with Analysis of Clinical Course of the Flap Using Infrared Thermal Camera

“…On POD 3 and POD 7, the average temperature in the necrotic area did not significantly differ from the total flap area, likely due to the influence of core body temperature (Table 1). Since rats have minimal dorsal fat tissue, the skin flap is in direct contact with the body core, which affects the temperature distribution [35]. This core temperature effect minimized the temperature gradient between necrotic and non-necrotic areas, making the impact of external factors more prominent.…”

Thermal Imaging as a Method to Indirectly Assess Peripheral Vascular Integrity and Tissue Viability in Veterinary Medicine: Animal Models and Clinical Applications

“…Then, 24 h after flap placement, the correct blood flow through perforators was assessed with IRT and macroscopical (necropsy) observations. Necrosis occurred in places where IRT did not detect perforators in 12 of 31 cases [ 80 ].…”