PDF(Pubmed)
Abstract：
OBJECTIVE: Successful outcomes in head and neck surgery rely on maintaining perfusion in pedicled skin flaps. Thermal imaging offers a noninvasive means to assess tissue perfusion, potentially aiding in predicting flap viability. This pilot study explores the utility of SBTI (smartphone-based thermal imaging) for predicting flap vitality and monitoring during surgery.
METHODS: Thermal imaging was employed using the FLIR One System. An imaging protocol was established, defining points of interest (T1-T4) on pedicled skin flaps. Conducted over four months, the study integrated SBTI into reconstructive surgery for the face, head and neck defects post-tumor resections. SBTI\'s effectiveness was assessed with n = 11 pedicled flaps, capturing images at key stages and correlating them with clinical flap assessment. Thermal images were retrospectively graded by two surgeons, evaluating flap perfusion on a scale from 1 to 5, based on temperature differences (1 = ΔT < 2 °C, 2 = ΔT ≥ 2 °C, 3 = ΔT ≥ 4 °C, 4 = ΔT ≥ 6 °C, and 5 = ΔT ≥ 8 °C), with assessments averaged for consensus and compared with the clinical assessment control group.
RESULTS: The study encountered challenges during implementation, leading to the exclusion of six patients. Patient data included 11 cases with n = 44 SBTI images. Intraoperative assessments consistently showed good perfusion. One postoperative dehiscence was noted, which retrospectively coincided with intraoperative SBTI grading, but not with clinical assessment. Statistical analysis indicated consistent outcomes following clinical and SBTI assessments. Thermal imaging accurately predicted flap viability, although it had limitations with small flaps.
CONCLUSIONS: SBTI proved effective, inexpensive, and noninvasive for assessing tissue perfusion, showing promise for predicting flap viability and intraoperative monitoring in head and neck surgery.
METHODS: Thermal imaging was employed using the FLIR One System. An imaging protocol was established, defining points of interest (T1-T4) on pedicled skin flaps. Conducted over four months, the study integrated SBTI into reconstructive surgery for the face, head and neck defects post-tumor resections. SBTI\'s effectiveness was assessed with n = 11 pedicled flaps, capturing images at key stages and correlating them with clinical flap assessment. Thermal images were retrospectively graded by two surgeons, evaluating flap perfusion on a scale from 1 to 5, based on temperature differences (1 = ΔT < 2 °C, 2 = ΔT ≥ 2 °C, 3 = ΔT ≥ 4 °C, 4 = ΔT ≥ 6 °C, and 5 = ΔT ≥ 8 °C), with assessments averaged for consensus and compared with the clinical assessment control group.
RESULTS: The study encountered challenges during implementation, leading to the exclusion of six patients. Patient data included 11 cases with n = 44 SBTI images. Intraoperative assessments consistently showed good perfusion. One postoperative dehiscence was noted, which retrospectively coincided with intraoperative SBTI grading, but not with clinical assessment. Statistical analysis indicated consistent outcomes following clinical and SBTI assessments. Thermal imaging accurately predicted flap viability, although it had limitations with small flaps.
CONCLUSIONS: SBTI proved effective, inexpensive, and noninvasive for assessing tissue perfusion, showing promise for predicting flap viability and intraoperative monitoring in head and neck surgery.
摘要：
目的：头颈部手术的成功结果依赖于维持带蒂皮瓣的灌注。热成像提供了一种非侵入性的方法来评估组织灌注，可能有助于预测皮瓣的生存能力。这项初步研究探讨了SBTI（基于智能手机的热成像）在手术期间预测皮瓣活力和监测的实用性。
方法：使用FLIROne系统进行热成像。建立了成像协议，在带蒂皮瓣上定义兴趣点（T1-T4）。进行了四个多月，这项研究将SBTI整合到面部重建手术中，肿瘤切除后的头颈部缺损。用n=11带蒂皮瓣评估SBTI的有效性，在关键阶段捕获图像，并将其与临床皮瓣评估相关联。两名外科医生对热图像进行了回顾性分级，根据温度差异（1=ΔT<2°C，2=ΔT≥2°C,3=ΔT≥4℃,4=ΔT≥6°C,且5=ΔT≥8°C)，并将评估结果平均为共识，并与临床评估对照组进行比较。
结果：该研究在实施过程中遇到了挑战，导致6名患者被排除在外。患者数据包括11例，n=44SBTI图像。术中评估始终显示良好的灌注。注意到一次术后裂开，回顾性分析与术中SBTI分级相吻合，但没有临床评估。统计学分析表明在临床和SBTI评估后结果一致。热成像准确预测皮瓣的生存能力，尽管它有小皮瓣的局限性。
结论：SBTI被证明是有效的，便宜,非侵入性评估组织灌注，在头颈部手术中显示出预测皮瓣活力和术中监测的希望。
方法：使用FLIROne系统进行热成像。建立了成像协议，在带蒂皮瓣上定义兴趣点（T1-T4）。进行了四个多月，这项研究将SBTI整合到面部重建手术中，肿瘤切除后的头颈部缺损。用n=11带蒂皮瓣评估SBTI的有效性，在关键阶段捕获图像，并将其与临床皮瓣评估相关联。两名外科医生对热图像进行了回顾性分级，根据温度差异（1=ΔT<2°C，2=ΔT≥2°C,3=ΔT≥4℃,4=ΔT≥6°C,且5=ΔT≥8°C)，并将评估结果平均为共识，并与临床评估对照组进行比较。
结果：该研究在实施过程中遇到了挑战，导致6名患者被排除在外。患者数据包括11例，n=44SBTI图像。术中评估始终显示良好的灌注。注意到一次术后裂开，回顾性分析与术中SBTI分级相吻合，但没有临床评估。统计学分析表明在临床和SBTI评估后结果一致。热成像准确预测皮瓣的生存能力，尽管它有小皮瓣的局限性。
结论：SBTI被证明是有效的，便宜,非侵入性评估组织灌注，在头颈部手术中显示出预测皮瓣活力和术中监测的希望。
