Infrared surface temperature monitoring in the postoperative management of free tissue transfers.
BACKGROUND
Early identification of failing free flaps may allow for potential intervention and flap salvage. The predictive ability of flap temperature monitoring has been previously questioned. The present study investigated the ability of an infrared surface temperature monitoring device to detect trends in flap temperature and correlation with anastomotic thrombosis and flap failure.


METHODS
Postoperative measurement of surface temperature was obtained in 47 microvascular free flaps. Differences in temperature between survival and failure groups were evaluated for statistical significance using Student's t test (P<0.05). In addition, a single variable analysis was performed on 30 different flap characteristics to evaluate their prediction of flap failure.


RESULTS
In total, eight flaps failed. Five of these were re-explored, of which one was salvaged. The three other flaps died a progressive death secondary to presumed thrombosis of the microcirculation despite adequate Doppler signals. Temperatures of the flap failure group during the last 24 h yielded a mean difference of 2 degrees C (3.56 degrees F) compared with surviving flaps (P<0.05). The temperature of the failing flaps began to decline at the eighth postoperative hour. Single variable analysis identified prior radiation to be a predictor of flap failure.


CONCLUSIONS
A surface temperature measurement device provides reproducible digital readings without physical contact with the flap. Technical difficulties encountered in previous research with implantable or surface contact temperature probes are obviated with this noncontact technique. Flap temperature monitoring revealed a trend in temperature that correlates with anastomotic thrombosis and eventual flap failure.
Papillion
Paul
P
Department of General Surgery;
Wong
Lesley
L
Waldrop
Jimmy
J
Sargent
Larry
L
Brzezienski
Mark
M
Kennedy
Woody
W
Rehm
Jason
J
Plast Reconstr Surg. 1992 Mar;89(3):495-9; discussion 500-2
1741473
Ann Plast Surg. 1987 Jul;19(1):34-41
3631857
Plast Reconstr Surg. 1983 Apr;71(4):519-24
6402796
Plast Reconstr Surg. 1976 May;57(5):577-95
775508
Ann Plast Surg. 2006 Sep;57(3):279-84
16929195
Otolaryngol Head Neck Surg. 2006 Nov;135(5):714-8
17071300
Clin Plast Surg. 1985 Apr;12(2):185-95
3157528
J Plast Reconstr Aesthet Surg. 2008;61(1):71-7
17532278
Nucl Med Commun. 2006 Jan;27(1):91-8
16340728
J Hand Surg Am. 1991 Nov;16(6):1056-62
1748752
J Reconstr Microsurg. 2007 May;23(4):189-97
17530610
Plast Reconstr Surg. 1981 Oct;68(4):543-55
7280101