Importance of thermometry in monitoring of the flaps

Abstract

Introduction: Complications highlighted in the postoperative period remains to be one of the current problems of reconstructive surgery, which has a relatively increased incidence (5-17%). Aim: evaluation of diagnostic value of local thermometry of flaps for early detection of complications.

Material and methods: The study group was 36 patients treated in the period 2014-2015 within the IEM, women - 10 (27.8%), men - 26 (72.2%). The limits of age were 16-70 years, with mean age 44.7 years. The thermometry was performed with an electronic thermometer with an accuracy of 0.1 0C and the data were recorded in the form of thermal curves. The temperature of the receiving areas were considered baseline values that were compared to the thermometric values of the flaps. Duration of monitoring was from 1 postoperative day to 1 year, at 2-3 months range. Data were statistically analyzed using the "step by step regression" with truthful coefficients.

Results: In the study group were 30(83.3%) island flaps, free – 6 (16.7%) cases. Thermometric differences in the postoperative period ZR/ZD >20C were found in 6 (16.7%) cases: island flaps – 4 (13.3%) cases, free – 2 (33.3%) cases. If the island complications occurred in 8( 26.7%) cases, free – two (33.3%) cases. Free flap complications: venous insufficiency due to anastomosis’s thrombosis (n=1), marginal necrosis (n=1) and insufficiency of anastomosis due to adjacent tissue’s edema (n=1). Complications of island flaps were: marginal necrosis (n=4), vascular insufficiency due to edema (n=3) and loss of the flap (n=1).

Conclusions: In the early postoperative period thermometric difference >20C indicates a flap’s vascular suffering that requires urgent actions. In the case of island flaps the thermometry has a sensitivity of approximately 85%, while in the case of free - 95%, the specificity is 98% in both.