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Abstrakty
Introduction: The primary goal of head and neck cancer surgery is the restoration of vital functions. To achieve this, after tumor ablation, lost tissues are reconstructed using free flaps (FF) or pedicled flaps simultaneously. Many objective monitoring techniques of flap perfusion have been explored, but none of them has been recognized as the gold standard. The aim of this study was to determine the feasibility of using infrared thermography (IRT) to assess the viability of FF and pedicled flaps in head and neck reconstructive surgery. Material and Methods: 14 flap reconstructions in patients diagnosed with oral cancer were investigated. One flap from the entire study group developed signs of necrosis. The temperature parameters taken from static IRT were average temperature derived every day from the day before surgery till the sixth day after and were described as Tavei, where i is the day after surgery. Moreover, the difference in average temperature changes between the target (TTave) and surrounding (TSave) ΔT = TTave – TSave was taken into consideration. Results: A larger decrease in the average temperature between day 5 and day 6 is observed for the surrounding. The average temperature of the flap changes till the 6th day after surgery, and the lowest temperature of the flap is described on the last day of study. Despite a wide range of the standard deviation results for the study group each day after reconstruction, the temperature values obtained for the patient with necrosis were always beyond it. The differences between ΔT parameter obtained for the whole studied group and the patient with necrotic flap are significant every day after surgery. Conclusions: Temperature difference (ΔT) between the target and its surrounding seems to be the proper parameter for the prediction of surgery results. However, due to the small study group, it should be taken only as a preliminary result, which should be confirmed in further studies on the bigger study group of patients.
Słowa kluczowe
Rocznik
Tom
Strony
73--80
Opis fizyczny
Bibliogr. 22 poz., rys.
Twórcy
autor
- Department of Cranio-Maxillo-Facial Surgery, Medical University of Silesia in Katowice, Katowice, Poland
autor
- Faculty of Science and Technology, University of Silesia, Katowice, Poland
autor
- Faculty of Science and Technology, University of Silesia, Katowice, Poland
autor
- Department of Cranio-Maxillo-Facial Surgery, Medical University of Silesia in Katowice, Katowice, Poland
Bibliografia
- 1. Katna R, Girkar F, Tarafdar D, et al. Pedicled Flap vs. Free Flap Reconstruction in Head and Neck Cancers: Clinical Outcome Analysis from a Single Surgical Team. Indian J Surg Oncol. 2021;12(3):472-476. https://doi.org/10.1007/s13193-021-01353-1
- 2. Frohwitter G, Nobis CP, Weber M, et al. Thermal Imaging in a Clinically Non-assessable Free Flap Reconstruction of the Face. Plastic and Reconstructive Surgery - Global Open. 2021;9(2):e3440. https://doi.org/10.1097/GOX.0000000000003440
- 3. Shokri T, Lighthall JG. Perfusion dynamics in pedicled and free tissue reconstruction: Infrared thermography and laser fluorescence video angiography. American Journal of Otolaryngology. 2021;42(2):102751. https://doi.org/10.1016/j.amjoto.2020.102751
- 4. Just M, Chalopin C, Unger M, et al. Monitoring of microvascular free flaps following oropharyngeal reconstruction using infrared thermography: first clinical experiences. Eur Arch Otorhinolaryngol. 2015;273(9):2659-2667. https://doi.org/10.1007/s00405-015-3780-9
- 5. Abdel-Galil K, Mitchell D. Postoperative monitoring of microsurgical free tissue transfers for head and neck reconstruction: a systematic review of current techniques—Part I. Non-invasive techniques. British Journal of Oral and Maxillofacial Surgery. 2009;47(5):351-355. https://doi.org/10.1016/j.bjoms.2008.11.013
- 6. Cruz-Segura A, Cruz-Domínguez MP, Jara LJ, et al. Early Detection of Vascular Obstruction in Microvascular Flaps Using a Thermographic Camera. J Reconstr Microsurg. 2019;35(07):541-548. https://doi.org/10.1055/s-0039-1688749
- 7. Zhang Y, Xiao W, Ng S, et al. Infrared thermography-guided designing and harvesting of pre-expanded pedicled flap for head and neck reconstruction. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2021;74(9):2068-2075. https://doi.org/10.1016/j.bjps.2020.12.102
- 8. Hanasono MM. Reconstructive Surgery for Head and Neck Cancer Patients. Advances in Medicine. 2014;2014:1-28. https://doi.org/10.1155/2014/795483
- 9. Lohman R, Langevin CJ, Bozkurt M, Kundu N, Djohan R. A Prospective Analysis of Free Flap Monitoring Techniques: Physical Examination, External Doppler, Implantable Doppler, and Tissue Oximetry. J Reconstr Microsurg. 2012;29(01):051-056. https://doi.org/10.1055/s-0032-1326741
- 10. Knoedler S, Hoch CC, Huelsboemer L, et al. Postoperative free flap monitoring in reconstructive surgery—man or machine? Front Surg. 2023;10. https://doi.org/10.3389/fsurg.2023.1130566
- 11. Perng CK. Recent advances in postoperative free microvascular flap monitoring. Formosan Journal of Surgery. 2013;46(5):145-148. https://doi.org/10.1016/j.fjs.2013.05.006
- 12. Chava SK, Agrawal M, Vidya K, et al. Role of Infrared Thermography in Planning and Monitoring of Head and Neck Microvascular Flap Reconstruction. Plastic and Reconstructive Surgery - Global Open. 2023;11(9):e5158. https://doi.org/10.1097/GOX.0000000000005158
- 13. Raheman, F.J., Rojoa, D.M., Patel, N.G. Performance of infrared thermography and thermal stress test in perforator mapping and flap monitoring: A meta-analysis of diagnostic accuracy. J Plast Reconstr Aesthet Surg. 74, 2013-2025 (2021).https://doi.org/10.1016/j.bjps.2021.03.088
- 14. Raheman FJ, Rojoa DM, Patel NG. Performance of infrared thermography and thermal stress test in perforator mapping and flap monitoring: A meta-analysis of diagnostic accuracy. Journal of Plastic, Reconstructive and Aesthetic Surgery. 2021;74(9):2013-2025. https://doi.org/10.1002/hed.26350
- 15. Englisz-Jurgielewicz B, Cholewka A, Firganek E, et al. Evaluation of hyperbaric oxygen therapy effects in hard-to-heal wounds using thermal imaging and planimetry. J Therm Anal Calorim. 2019;141(4):1465-1475. https://doi.org/10.1007/s10973-019-09129-0
- 16. Corbitt C, Skoracki RJ, Yu P, Hanasono MM. Free flap failure in head and neck reconstruction. Head and Neck. 2014;36(10):1440-1445. https://doi.org/10.1002/hed.23471
- 17. Lineaweaver WC. Book Review—Retired Not Dead: Thoughts Plastic Surgical and Otherwise. Annals of Plastic Surgery. 2009;63(3):240. https://doi.org/10.1097/SAP.0b013e3181b597d8
- 18. Khouri RK, Shaw WW. Monitoring of free flaps with surface temperature recordings: is it reliable? Plast Reconstr Surg. 1992;89(3):495-499.
- 19. Copelli C, Tewfik K, Cassano L, et al. Management of free flap failure in head and neck surgery. Acta Otorhinolaryngol Ital. 2017;37(5):387-392. https://doi.org/10.14639/0392-100X-1376
- 20. Kasprzyk-Kucewicz T, Cholewka A, Englisz-Jurgielewicz B, et al. Thermal Effects of Topical Hyperbaric Oxygen Therapy in Hard-to-Heal Wounds—A Pilot Study. IJERPH. 2021;18(13):6737. https://doi.org/10.3390/ijerph18136737
- 21. Mercer JB, de Weerd L. The effect of water-filtered infrared-A (wIRA) irradiation on skin temperature and skin blood flow as evaluated by infrared thermography and scanning laser Doppler imaging. Thermology Int. 2005;15:89-94.
- 22. Lohman RF, Ozturk CN, Ozturk C, Jayaprakash V, Djohan R. An Analysis of Current Techniques Used for Intraoperative Flap Evaluation. Annals of Plastic Surgery. 2015;75(6):679-685. https://doi.org/10.1097/SAP.0000000000000235
Uwagi
Opracowanie rekordu ze środków MNiSW, umowa nr POPUL/SP/0154/2024/02 w ramach programu "Społeczna odpowiedzialność nauki II" - moduł: Popularyzacja nauki (2025).
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-042814cd-5607-4c00-8ced-21a64dc1d854
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