Temperature Change on the Skin in Hand After Replantation and Free Flap

초록

Background A skin of the hand had undergone replantation or free flap are known to be vulnerable to heat injury. The purpose of this study was to try to find the difference of thermoregulatory function between the skin on the hand with microsurgery and that on opposite normal hand during heat exposure. Methods From 2010 to 2014, patients who had undergone replantation, free flap, tendon and bone surgery in hand were divided into four groups, that were digital replantation (Group A), free flaps (Group B), hand surgery without microsurgery (Group C), and opposite normal hand (Control). These groups were subdivided by postoperative period; <6 months, 7 to 12 months, and 12 to 24 months. We checked the skin temperature after an infra-red warming therapy for evaluate thermoregulatory function of the skin. Differences and group characteristics were compared. Results In group A and B, mean base temperatures on skin were always lower than control group. Within 12 months, from 5 minutes to 30 minutes after warming, temperature on skin was higher than that on control. After 12 months, until 15 minutes after warming, temperatures on skin were lower than that of on control. After 20 minutes, temperature on skin was higher than that on control. In the Group C, no temperature differences were always observed between skin on group C and that on control. Conclusion Skin of the replantation and free flap in hands have dysfunction of the thermoregulation around 12 months after microsurgery, which could result in heat accumulation and reducing resistance to heat injury. Thermoregulatory function was not fully recovered at about 24 months after microsurgery.