Temperature Monitoring and Temperature Change Pattern in H &N reconstruction using free flap

초록

Background Areas that have undergone microsurgery are known to be vulnerable to heat injury, but the reason for this has not been established. The purpose of this study was to investigate abnormal thermoregulatory function by examining differences between normal and microsurgical tissues exposed to heat. Methods Seventy patients that had undergone microsurgical hand surgery involving free flap or replantation surgery and 13 patients that underwent hand surgery without microsurgery were selected for this study. These 83 patients were divided into three groups, that is, into two microsurgery groups (replantation of finger amputation (Group A) and a free flap (Group B)), and a group that had not undergone microsurgery (Group C). These groups were subdivided for analysis by postoperative period, as follows; <6 months, 7 to 12 months, and 12 to 24 months. All patients received warming therapy with an infra-red heat lamp for 30 minutes, during which skin surface temperatures of surgical areas and corresponding areas on contralateral hands were measured every 5 minutes. Skin temperature differences and group characteristics were compared and analyzed. Results In group A and B, mean baseline temperature was higher at normal areas than on microsurgery areas within 24 months. Within 12 months after microsurgery, the temperature of microsurgery areas increased more rapidly and was higher than normal areas after 5 minutes (P<0.05). At 12 to 24 months after surgery, the temperature of microsurgery areas increased more and was higher than normal areas after 20 minutes with no statistically significant. In the Group C, no temperature differences were observed between surgical areas and contralateral normal areas at any time. Conclusion This research suggests replantation and free flap tissue reconstruction in hands causes thermoregulatory dysfunction for 24 months, which could result in heat accumulation in tissues, increases the risk of thermal injury, and reduces tis