红外热成像技术在游离股前外侧皮瓣修复创面血运监测中的应用  

Application of infrared thermography technology in monitoring blood supply of wound repaired by free anterolateral femoral flap

作　　者：林伟栋 糜菁熠 潘筱云 张志海 Lin Weidong;Mi Jingyi;Pan Xiaoyun;Zhang Zhihai(Department of Hand Surgery,Wuxi 9th People's Hospital Afiliated to Suzhou University,Wuxi 214062,China)

机构地区：[1]无锡市第九人民医院手外科,无锡214062

出　　处：《中华手外科杂志》2022年第4期312-314,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨红外热成像技术在游离股前外侧皮瓣修复创面血运监测中的应用,为临床提供经验及参考。方法自2020年8月至2021年4月,我们对18例行游离股前外侧皮瓣修复创面的患者,在术中及术后分别采用红外热成像技术对皮瓣的血运情况进行监测,观察热像图变化情况。.结果术中所有皮瓣在断蒂前的热像图上均可在穿支穿出点观察到热点的复温过程。术中在血管吻合后,16例皮瓣在动态热像图上观察到穿支血管处有热点快速出现,然后皮瓣周围逐渐升温,并可见额外新的热点生成;1例皮瓣松止血带后皮瓣复温不明显,未观察到明显的热点出现,该皮瓣经动脉抗痉挛治疗后好转,在热像图上表现为热点快速出现;1例皮瓣在热点出现后,穿支血管处的热点先逐渐弥散扩大再缩小,其他热点逐渐消失,经切除静脉栓塞血管并重新吻合通血后,血运情况改善。术后所有皮瓣均可在热像图上观察到明显的热点。术后2周所有皮瓣均存活,伤口均Ⅰ期愈合,皮瓣质地,血运良好。结论红外热成像技术应用于游离股前外侧皮瓣修复创面的血运监测,方法简单可靠,可以直观快速反映皮瓣的血运情况,有助于尽早发现皮瓣血运障碍,有较高的应用价值。Objective To explore the application of infrared thermography technology in monitoring blood supply of wound repaired by free anterolateral femoral flap,so as to provide experience and reference for clinical practice.MethodsFrom August 2020 to April 2021,we monitored the blood supply of 18 patients with wound treated by free anterolateral femoral flap transplantation during and after operation,and observed the changes of thermogram.ResultsDuring the operation,the rewarming process of hot spots can be observed at the exit point of perforator on the thermogram of all flaps before pedicle breaking.During the operation,after vascular anastomosis,hot spots appeared rapidly at the perforator vessels in 16 flaps on dynamic thermogram,and then gradually heated up around the flap,and additional new hot spots were observed.In one case,the flap rewarming was not obvious after loosening the tourniquet,and no obvious hot spots were observed.The flap improved after arterial antispasmodic treatment,and the hot spots appeared rapidly on the thermogram.In one case,after the hot spot appeared,the hot spot at the perforator vessel gradually diffused,expanded and then narrowed,and other hot spots gradually disappeared.After removing the embolic vessels of the vein and anastomosing again,the blood circulation was improved.Obvious hot spots were observed on the thermogram of all the flaps after operation.Two weeks after operation,all the flaps survived,the wounds achieved primary healing,and the texture and blood supply of the flap were good.ConclusionThe application of infrared thermography technology in monitoring blood supply of wound repaired by free anterolateral femoral flap is simple and reliable.It can directly and quickly reflect the blood supply of the flap,help to find the blood supply disorder of the flap as soon as possible,and has high application value.

关 键 词：外科皮瓣 移植 红外热成像 血运监测 

分 类 号：R687[医药卫生—骨科学]