Thermal Imaging Assessment of Cicatrical Tissue Capabilities in Facioplasty Planning

The aim of the investigation was to study the capabilities of thermal imaging to estimate the functional reserves of blood supply of facial cicatricial tissues used in skin grafting.

Materials and Methods. Using an infrared thermal imager Thermo Tracer ТН-9100 we examined 37 patients with post-burn scars on the face and anterior surface of the neck (total: 126 scar areas planned for flap dissection) and 4 healthy volunteers. After recording a native (original) thermal picture, we carried out a standard local alcohol test with further monitoring of space-time temperature dynamics for 7 min. To develop a criterion of tissue suitability for skin grafting, we calculated ∆Т=Тinit–Тfin, where Тinit was the initial temperature before the test, and Тfin — the temperature on the 7th minute of test recovery.

Results. The obtained data on the thermal reaction dynamics of cicatricial tissues enable to evaluate the capability to use these tissues as skin grafting material. The criteria are based on thermal imaging findings of the dynamics of initial temperature recovery of healthy and cicatrical tissues. If the temperature difference by the 7th minute of the examined tissues is below 0.9°С by the end of the alcohol test, the tissues can be used for skin grafting. The temperature recovery lag by more than 1.9°С indicates inapplicability of cicatricial tissues for skin grafting. The temperature difference in the range from 0.9 to 1.9°С should be considered risky.

Conclusion. The developed thermal image technique to assess the functional state of facial cicatricial tissue blood supply enables to determine the criteria of cicatrical tissue availability for minor facioplasty, and differentiate suitable and unsuitable tissues.

1. D'Souza A.L., Nelson N.G., McKenzie L.B. Pediatric burn injuries treated in US emergency departments between 1990 and 2006. Pediatrics 2009; 124(5): 1424–1430,http://dx.doi.org/10.1542/peds.2008-2802.
2. Park S. Mestnye i regional’nye kozhnye loskuty. V kn.: Plasticheskaya i rekonstruktivnaya khirurgiya litsa [Local and regional skin flaps. In: Facial surgery and reconstructive surgery]. Pod red. Peypla A.D. [Peypla A.D. (editor)]. Moscow: BINOM. Laboratoriya znaniy; 2007; p. 565–585.
3. Korotkova N.L., Ivanov S.Yu. Surgical approach in patients after face burn after-effects. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy khirurgii 2012; 4: 10–17.
4. Dmitriev G.I., Korotkova N.L., Okhotina L.A., Bogos'yan R.A. New surgical technologies in the treatment of sequellae of burns of face and neck. Travmatologiya zhәne ortopediya 2008; 1(13): 97–99.
5. Sarygin P.V. Khirurgicheskoe lechenie posledstviy ozhogov shei i litsa. Avtoref. dis. … dokt. med. nauk [Surgical treatment of sequellae of burns of face and neck. Abstract for the Doctoral degree of Medical Sciences]. Moscow; 2005.
6. Barkhudarova N.R. Povyshenie effektivnosti khirurgicheskoy reabilitatsii detey s posleozhogovymi rubtsovymi deformatsiyami i kontrakturami sustavov konechnostey s ispol'zovaniem rekonstruktivno-plasticheskikh operatsiy. Avtoref. dis. … kand. med. nauk [Enhancement of efficiency of surgical rehabilitation of children with postburn cicatrical deformities and contractures of extremity joints using reconstructive operation. Abstract for the Dissertation of Candidate of Medical Sciences]. Moscow; 2009.
7. Volovik M.G., Korotkova N.L. Primenenie teplovideniya dlya otsenki krovosnabzheniya posleozhogovykh rubtsov litsa. V kn.: Trudy X Mezhdunar. konf. “Prikladnaya optika-2012” [Thermal imaging application to estimate blood supply of after burn facial scars. In: Proceedings of X International Conference “Applied optics-2012”]. Saint Petersburg; 2012; p. 136–140.
8. Tenorio X., Mahajan A., Montandon D., Pittet B. Dynamic infrared imaging in reconstructive surgery. Plastic and Reconstructive Surgery 2005; 116(3): 147–149, http://dx.doi.org/10.1097/00006534-200509011-00123.
9. Pau H.W., Sievert U., Graumüller S., Wild E. Incisions for cochlear implant flaps and superficial skin temperature. Skin temperature/blood circulation in CI flaps. Otolaryngol Pol 2004; 58(4): 713–719.
10. Chubb D., Rozen W.M., Whitaker I.S., Ashton M.W. Images in plastic surgery: digital thermographic photography (“thermal imaging”) for preoperative perforator mapping. Ann Plast Surg 2011; 66(4): 324–325, http://dx.doi.org/10.1097/SAP.0b013e31820bcc5e.
11. de Weerd L., Weum S., Mercer J.B. Dynamic infrared thermography: a useful tool in the preoperative planning of deep inferior epigastric perforator flaps. Ann Plast Surg 2012; 68(6): 639–640, http://dx.doi.org/10.1097/SAP.0b013e318244413a.
12. Ring E.F.J., Ammer K. Infrared thermal imaging in medicine. Physiol Meas 2012; 33(3): R33–R46, http://dx.doi.org/10.1088/0967-3334/33/3/R33.
13. Volovik M.G., Vodop’yanov K.A. Thermal imaging quality control of prolonged regional anesthesia in children. Rossiyskiy neyrokhirurgicheskiy zhurnal im. A.L. Polenova 2011; 3(special issue): 18–21.
14. Nedeleс B., Shankowsky H.A., Tredget E.E. Rating the resolving hypertrophic scar: comparison of vancouver scar scale and scar volume. J Burn Care Rehabil 2000; 21(3): 205–212, http://dx.doi.org/10.1097/00004630-200021030-00005.
15. Мustoe T.A., Cooter R., Gold M.H., Hobbs R., Ramelet A.-A., Shakespeare P., et al. International clinical recommendations on scar management. Plastic and Reconstructive Surgery 2002; 110(2): 560–571, http://dx.doi.org/10.1097/00006534-200208000-00031.
16. Okhotina L.A. Khirurgicheskaya reabilitatsiya bol’nykh s rubtsovymi deformatsiyami i kontrakturami shei posle ozhoga. Avtoref. dis. ... kand. med. nauk [Surgical rehabilitation of patients with cicatrical deformities and contractures of neck after burns. Abstract for the Dissertation of Candidate of Medical Sciences]. Nizhny Novgorod; 1997.
17. Cheremisina E.N., Basha N.S. Personal identification by thermal imaging of face: the current state, development prospects. Sistemnyy analiz v nauke i obrazovanii 2012; 2. URL: http://www.sanse.ru/archive/24.
18. Durnovo E.A., Potekhina Yu.P., Marochkina M.S., Mochalova D.A. Development and analysis of thermal maxillofacial mapping according to sex and age. Rossiyskiy stomatologicheskiy zhurnal 2013; 3: 4–9.

Korotkova N.L., Volovik М.G. Thermal Imaging Assessment of Cicatrical Tissue Capabilities in Facioplasty Planning. Sovremennye tehnologii v medicine 2015; 7(2): 120, https://doi.org/10.17691/stm2015.7.2.16