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Valença-Filipe R, Vardasca R, Magalhães C, Mendes J, Amarante J, Costa-Ferreira A. Classic Versus Scarpa-sparing abdominoplasty: An infrared thermographic comparative analysis. J Plast Reconstr Aesthet Surg 2023; 82:264-274. [PMID: 37209599 DOI: 10.1016/j.bjps.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/12/2023] [Accepted: 04/07/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Scarpa fascia preservation during abdominoplasty has been shown to have several clinical advantages. The mechanisms behind its efficiency have been the subject of several studies. Three theories have been proposed, relating to mechanical factors, lymphatic preservation, and improved vascularization. This study aimed to further investigate the possible vascular impact of Scarpa fascia preservation by using a thermographic analysis. METHODS A single-center prospective study was conducted, involving 12 female patients randomly and equally assigned to one of two surgical procedures: classic (Group A) and Scarpa-sparing abdominoplasty (Group B). Dynamic thermography was applied before and after surgery (one and six months), and two regions of interest (ROIs) were considered. The latter had the same location on every sample, and corresponded to areas where different surgical planes had been used. Static thermography was applied intraoperatively, and four ROIs were considered, located over Scarpa and over the deep fascia. The respective thermal data were analyzed. RESULTS The general characteristics of both groups were identical. Preoperative thermography demonstrated no differences between groups. Intraoperative higher thermal gradients between lateral and medial ROIs were observed in Group B (P = 0.037, right side). Dynamic thermography at one month demonstrated a trend for better thermal recovery and better thermal symmetry (P = 0.035, 1-min mark) in Group B. No other differences were found. CONCLUSION Dynamic thermography presented a better response when Scarpa fascia was preserved: stronger, faster, and more symmetric. Based on these results, improved vascularization may have a role in explaining the clinical efficiency of a Scarpa-sparing abdominoplasty.
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Affiliation(s)
- Rita Valença-Filipe
- Department of Surgery and Physiology, Faculty of Medicine, Porto University, Porto, Portugal; FMR Clinic - Aesthetic Surgery, Porto, Portugal.
| | - Ricardo Vardasca
- LABIOMEP, INEGI-LAETA, Porto University, Porto, Portugal; ISLA-Santarém, Santarém, Portugal
| | - Carolina Magalhães
- LABIOMEP, INEGI-LAETA, Porto University, Porto, Portugal; Faculty of Engineering, University of Porto, Portugal
| | - Joaquim Mendes
- LABIOMEP, INEGI-LAETA, Porto University, Porto, Portugal; Faculty of Engineering, University of Porto, Portugal
| | - José Amarante
- Department of Surgery and Physiology, Faculty of Medicine, Porto University, Porto, Portugal; LABIOMEP, INEGI-LAETA, Porto University, Porto, Portugal; Department of Plastic, Aesthetic and Reconstructive Surgery, São João University Hospital, Porto, Portugal; Porto University, Porto, Portugal
| | - António Costa-Ferreira
- Department of Surgery and Physiology, Faculty of Medicine, Porto University, Porto, Portugal; Department of Plastic, Aesthetic and Reconstructive Surgery, São João University Hospital, Porto, Portugal
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Childs C, Nwaizu H, Bullivant E, Willmott J, Davies M, Ousey K, Soltani H, Jacques R. Cutaneous Perfusion Dynamics of the Lower Abdomen in Healthy Normal Weight, Overweight and Obese Women: Methods Development Using Infrared Thermography with Applications for Future Wound Management after Caesarean Section. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5100. [PMID: 36982008 PMCID: PMC10048797 DOI: 10.3390/ijerph20065100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence has shown an association between obesity and an increased risk of wound infection after caesarean section. This study was designed to examine if abdominal subcutaneous adiposity impacts upon cutaneous perfusion dynamics. METHODS Mild cool challenge, followed by real-time video thermography, was developed to map the appearance of abdominal 'hot spots'. Correspondence of marked 'spots' with audible Doppler and colour and power Doppler ultrasound was performed. RESULTS 60 healthy, afebrile, women (20-68 years; BMI 18.5-44 kg/m2) were recruited. Hot spot appearance consistently corresponded with audible Doppler sounds. Colour and power Doppler ultrasound revealed vessels at depths of 3-22 mm. No statistically significant interactions for BMI, abdominal circumference or environmental parameters were observed for hot spot count. The temperature of cold stimulus was significant for effects on spot count, but only for the first minute (p = 0.001). Thereafter, effects on spot numbers were not significant. CONCLUSIONS Cutaneous 'perforator' mapping of the abdomen (via hot spot appearance) in healthy women, as a potential and future method for risk of perfusion-dependent wound healing complications, reveals that bedside mapping of skin perfusion is feasible over a short interval. Hot spot number was not influenced by BMI or indicators of central fat distribution (abdominal circumference) indicating variability in an individual's vascular anatomy. This study provides the underpinning methodology for personalised perfusion assessment after incisional surgery which may be a more reliable indicator of potential healing complications than body habitus as is currently the norm.
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Affiliation(s)
- Charmaine Childs
- Centre for Applied Health & Social Care Research, Health Research Institute, Sheffield Hallam University, Sheffield S10 2BP, UK (E.B.)
| | - Harriet Nwaizu
- Centre for Applied Health & Social Care Research, Health Research Institute, Sheffield Hallam University, Sheffield S10 2BP, UK (E.B.)
| | - Elizabeth Bullivant
- Centre for Applied Health & Social Care Research, Health Research Institute, Sheffield Hallam University, Sheffield S10 2BP, UK (E.B.)
| | - Jon Willmott
- Semiconductor Materials and Devices Research Group, Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield S10 2TN, UK; (J.W.); (M.D.)
| | - Matthew Davies
- Semiconductor Materials and Devices Research Group, Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield S10 2TN, UK; (J.W.); (M.D.)
| | - Karen Ousey
- Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield HD1 3DH, UK;
| | - Hora Soltani
- Centre for Applied Health & Social Care Research, Health Research Institute, Sheffield Hallam University, Sheffield S10 2BP, UK (E.B.)
| | - Richard Jacques
- Medical Statistic Group, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK;
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Study of flow, Bioheat transfer and cardiac thermal pulse of aneurysm in the abdominal aortic. J Therm Biol 2023; 113:103481. [PMID: 37055109 DOI: 10.1016/j.jtherbio.2023.103481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 11/06/2022] [Accepted: 01/10/2023] [Indexed: 02/17/2023]
Abstract
Abdominal aortic aneurysms (AAA) are serious and difficult to detect conditions that can be deadly if they rupture. Infrared thermography (IRT) is a promising imaging technique that can detect abdominal aortic aneurysms more quickly and less costly than other imaging techniques. A clinical biomarker of circular thermal elevation on the midriff skin surface of AAA patient at various scenarios was expected during diagnosis using IRT scanner. However, it is important to note that thermography is not a perfect technology, and it does have some limitations, such as lack of clinical trials. There is still work to be done to improve this imaging technique and make it a more viable and accurate method in detecting abdominal aortic aneurysms. Nevertheless, thermography is currently one of the most convenient technologies in imaging, and it has the potential to detect abdominal aortic aneurysms earlier than other techniques. Cardiac thermal pulse (CTP), on the other hand, was used to examine the thermal physics of AAA. AAA had a CTP that only responded to systolic phase at regular body temperature. Whereas the AAA wall would establish thermal homeostasis with blood temperature following a quasi-linear relationship as the body experienced fever or stage-2 hypothermia. In contrast, a healthy abdominal aorta displayed a CTP that responded to the full cardiac cycle, including diastolic phase at all simulated scenarios.
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Li F, Wang M, Wang T, Wang X, Ma X, He H, Ma G, Zhao D, Yue Q, Wang P, Ma M. Smartphone‐based infrared thermography to assess progress in thoracic surgical incision healing: A preliminary study. Int Wound J 2022. [DOI: 10.1111/iwj.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Fanfan Li
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
| | - Min Wang
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
| | - Ting Wang
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
| | - Xiaolan Wang
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
| | - Xiaoli Ma
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
- The First Clinical Medical College of Lanzhou University Lanzhou People's Republic of China
- Key Technology Development and Application of Thoracic Surgery Specialty Gansu Province International Science and Technology Cooperation Base Lanzhou People's Republic of China
- Medical Quality Control Center of Thoracic Surgery in Gansu Province Lanzhou People's Republic of China
| | - Hua He
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
| | - Guojing Ma
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
| | - Dan Zhao
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
| | - Qin Yue
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
| | - Panpan Wang
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
| | - Minjie Ma
- Department of Thoracic Surgery The First Hospital of Lanzhou University Lanzhou People's Republic of China
- Gansu University of Chinese Medicine Lanzhou People's Republic of China
- The First Clinical Medical College of Lanzhou University Lanzhou People's Republic of China
- Key Technology Development and Application of Thoracic Surgery Specialty Gansu Province International Science and Technology Cooperation Base Lanzhou People's Republic of China
- Medical Quality Control Center of Thoracic Surgery in Gansu Province Lanzhou People's Republic of China
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Itakura DA, Nakato AM, Hembecker PK, Neves EB, Nohama P. Thermal changes in the sacral region with different mattresses used in the prevention of pressure injuries. J Therm Biol 2022; 110:103366. [PMID: 36462883 DOI: 10.1016/j.jtherbio.2022.103366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/01/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Pressure Injury (PI) is a severe health problem that affects millions of people. As a preventive strategy for high-risk ICU patients, the appropriate selection of a support surface is essential for preventing PI, along with risk assessment and repositioning. Increasing skin temperature has been associated with a higher susceptibility to PI development. OBJECTIVE This study aimed to evaluate thermal variations related to skin pressure in the sacral area of healthy individuals lying on three different mattresses models (standard, inflatable air, and egg crate). DESIGN Experimental study. MAIN OUTCOMES Initially, a survey was performed to identify the mattresses models most used in four public university hospitals and preventive strategies adopted. And then, an experimental study was conducted with a non-probabilistic sample involving 28 individuals of both sexes, aged 18-35 years old. The volunteers were immobilized for 2 h, and temperature variations in the sacral region were obtained by acquiring thermal images. RESULTS A significant difference was not found in the temperature recorded on the three mattresses models before the experiment. However, there were significant differences at the 1st and 31st minute (p < 0.001). The lowest temperature values were identified in the air inflatable mattress. Post-hoc comparisons revealed a significant difference between standard or egg crate mattresses and the inflatable air model. CONCLUSION The inflatable air mattress should be considered for preventing pressure injury in ICU patients since the temperature had returned to the initial value (pre-test) after the 31st min. In addition to the appropriate selection surface, risk assessment and positioning are essential to PI prevention strategies.
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Affiliation(s)
- Daniela Akemi Itakura
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná (PUCPR), Brazil.
| | - Adriane Muller Nakato
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná (PUCPR), Brazil.
| | - Paula Karina Hembecker
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná (PUCPR), Brazil.
| | - Eduardo Borba Neves
- Graduate Program in Biomedical Engineering, Universidade Tecnológica Federal do Paraná (UTFPR), Brazil.
| | - Percy Nohama
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná (PUCPR), Brazil.
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Ng E, Looi LJC. Numerical analysis of biothermal-fluids and cardiac thermal pulse of abdominal aortic aneurysm. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:10213-10251. [PMID: 36031992 DOI: 10.3934/mbe.2022479] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Abdominal aortic aneurysms are serious and difficult to detect, conditions can be deadly if they rupture. In this study, the heat transfer and flow physics of Abdominal Aortic Aneurysm (AAA) were discussed and associated with cardiac cycle to illustrate the cardiac thermal pulse (CTP) of AAA. A CTP and infrared thermography (IRT) evaluation-based on AAA and abdomen skin surface detection method was proposed, respectively. Infrared thermography (IRT) is a promising imaging technique that may detect AAA quicker and cheaper than other imaging techniques (as biomarker). From CFD rigid-wall and FSI Analysis, the transient bioheat transfer effect resulted in a distinct thermal signature (circular thermal elevation) on the temperature profile of midriff skin surface, at both regular body temperature and supine position, under normal clinical temperature. However, it is important to note that thermography is not a perfect technology, and it does have some limitations, such as lack of clinical trials. There is still work to be done to improve this imaging technique and make it a more viable and accurate method for detecting abdominal aortic aneurysms. However, thermography is currently one of the most convenient technologies in this field, and it has the potential to detect abdominal aortic aneurysms earlier than other techniques. CTP, on the other hand, was used to examine the thermal physics of AAA. In CFD rigid-wall Analysis, AAA had a CTP that only responded to systolic phase at regular body temperature. In contrast, a healthy abdominal aorta displayed a CTP that responded to the full cardiac cycle, including diastolic phase at all simulated cases. Besides, the findings from FSI Analysis suggest the influence of numerical simulation techniques on the prediction of thermal physics behaviours of AAA and abdominal skin surface. Lastly, this study correlated the relationship between natural convective heat transfer coefficient with AAA and provided reference for potential clinical diagnostic using IRT in clinical implications.
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Affiliation(s)
- Eyk Ng
- School of Mechanical and Aerospace Engineering, College of Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798
| | - Leonard Jun Cong Looi
- School of Mechanical and Aerospace Engineering, College of Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore 639798
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