The use of thermography in assessing the viability of pedicled and free flaps used in head and neck reconstructive surgery – preliminary study

Introduction: The primary goal of head and neck cancer surgery is the restoration of vital functions. To achieve this, after tumor ablation, lost tissues are reconstructed using free flaps (FF) or pedicled flaps simultaneously. Many objective monitoring techniques of flap perfusion have been explored, but none of them has been recognized as the gold standard. The aim of this study was to determine the feasibility of using infrared thermography (IRT) to assess the viability of FF and pedicled flaps in head and neck reconstructive surgery. Material and Methods: 14 flap reconstructions in patients diagnosed with oral cancer were investigated. One flap from the entire study group developed signs of necrosis. The temperature parameters taken from static IRT were average temperature derived every day from the day before surgery till the sixth day after and were described as Tavei, where i is the day after surgery. Moreover, the difference in average temperature changes between the target (TTave) and surrounding (TSave) ΔT = TTave – TSave was taken into consideration. Results: A larger decrease in the average temperature between day 5 and day 6 is observed for the surrounding. The average temperature of the flap changes till the 6th day after surgery, and the lowest temperature of the flap is described on the last day of study. Despite a wide range of the standard deviation results for the study group each day after reconstruction, the temperature values obtained for the patient with necrosis were always beyond it. The differences between ΔT parameter obtained for the whole studied group and the patient with necrotic flap are significant every day after surgery. Conclusions: Temperature difference (ΔT) between the target and its surrounding seems to be the proper parameter for the prediction of surgery results. However, due to the small study group, it should be taken only as a preliminary result, which should be confirmed in further studies on the bigger study group of patients.

---

Opracowanie rekordu ze środków MNiSW, umowa nr POPUL/SP/0154/2024/02 w ramach programu "Społeczna odpowiedzialność nauki II" - moduł: Popularyzacja nauki (2025).