简介:剖腹产(CS)是女性最普遍的外科手术。CS后手术部位感染(SSI)的发生率仍然很高,但最近使用红外热成像技术对CS伤口的观察已显示出对SSI预后技术的希望。虽然热成像被认为是皮肤灌注的“替代品”,在伤口愈合的背景下,皮肤温度和皮肤灌注之间的关系知之甚少。目的:评估有关CS后红外热成像和腹部皮肤灌注图应用的文献范围。方法:使用广泛的合格标准来捕获任何设计的所有相关研究,以英文出版,和解决腹壁的热成像或皮肤灌注图。搜索了CINAHL和MEDLINE数据库,由两名独立审稿人筛选所有已确定引文的标题和摘要,其次是相关研究的全文筛选。使用预先指定的数据提取图表从纳入的研究中提取数据。数据以叙述格式制表和综合。结果:从确定的83篇引文中,18项研究被认为是相关的。从参考文献列表中确定了另外三项研究,通过全文筛选了21项研究。没有一项研究报道了前腹壁的热成像和皮肤灌注模式。然而,两项观察性研究部分符合纳入标准.首先探索了“询问”腹部热图的分析方法。特定的热特征(\'冷点\')被确定为SSI风险的早期\'标志\'。第二项研究,同样的作者,关注肥胖(CS后SSI的已知危险因素)显示,1°C下腹皮肤温度导致SSI的几率增加3倍.结论:关于如何预警CS后伤口并发症的知识存在明显差距。通过利用皮肤温度和血流量之间的已知关联,伤口和邻近热区域的热成像评估具有非侵入性的潜力,独立,用于识别“有风险”组织的成像选项。通过识别皮肤\'热\'或\'冷\'点,与高或低血流量区域相称,有可能揭示导致感染性和非感染性伤口并发症的潜在机制。
Introduction: Caesarean section (CS) is the most prevalent surgical procedure in women. The incidence of surgical site infection (SSI) after CS remains high but recent observations of CS wounds using infrared thermography has shown promise for the technique in SSI prognosis. Although thermography is recognised as a \'surrogate\' of skin perfusion, little is known of the relationship between skin temperature and skin perfusion in the context of wound healing. Aim: To assess the extent of literature regarding the application of infrared thermography and mapping of abdominal cutaneous perfusion after CS. Methods: Wide eligibility criteria were used to capture all relevant studies of any design, published in English, and addressing thermal imaging or skin perfusion mapping of the abdominal wall. The CINAHL and MEDLINE databases were searched, with two independent reviewers screening the title and abstracts of all identified citations, followed by full-text screening of relevant studies. Data extraction from included studies was undertaken using a pre-specified data extraction chart. Data were tabulated and synthesised in narrative format. Results: From 83 citations identified, 18 studies were considered relevant. With three additional studies identified from the reference lists, 21 studies were screened via full text. None of the studies reported thermal imaging and cutaneous perfusion patterns of the anterior abdominal wall. However, two observational studies partially met the inclusion criteria. The first explored analysis methodologies to \'interrogate\' the abdominal thermal map. A specific thermal signature (\'cold spots\') was identified as an early \'flag\' for SSI risk. A second study, by the same authors, focusing on obesity (a known risk factor for SSI after CS) showed that a 1 °C lower abdominal skin temperature led to a 3-fold odds of SSI. Conclusion: There is a significant gap in knowledge on how to forewarn of wound complications after CS. By utilising the known association between skin temperature and blood flow, thermographic assessment of the wound and adjacent thermal territories has potential as a non-invasive, independent, imaging option with which to identify tissue \'at risk\'. By identifying skin \'hot\' or \'cold\' spots, commensurate with high or low blood flow regions, there is potential to shed light on the underlying mechanisms leading to infective and non-infective wound complications.