Serial Static Infrared Thermography for Intraoperative and Postoperative Surface-Temperature Monitoring of Free-Flap Skin Islands in Paediatric Craniofacial Reconstruction: A Technical Feasibility Study
5 affiliations
- 1Faculty of Science and Technology, University of Silesia in Katowice, Bankowa 12, 40-007 Katowice, Poland
- 2Department of Clinical Paediatrics, Head and Neck Surgery Clinic for Children and Young Adults, University of Warmia and Mazury, Zołnierska 18a Street, 10-561 Olsztyn, Poland
- 3Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
- 4Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, The State University of New York, 3435 Main Street, Buffalo, NY 14214, USA
- 5Department of Dentistry, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic
Abstract
Background/Objectives: This single-patient retrospective study evaluated the technical feasibility of serial infrared thermography (IRT) for intraoperative and postoperative surface-temperature documentation of free-flap skin islands and its descriptive concordance with clinical and vascular assessments. Methods: A 9-year-old boy with Nager syndrome undergoing bilateral temporomandibular joint reconstruction and soft-tissue reconstruction with an anterolateral thigh free flap divided into two skin islands was monitored intraoperatively and postoperatively. Thermograms were acquired using a FLIR T1020 camera (emissivity 0.98) under documented environmental conditions. Intraoperative and postoperative observations were interpreted separately, without normalisation between settings. Mean temperatures within manually delineated regions of interest and inter-island differences were analysed retrospectively and compared descriptively with documented clinical assessment, Doppler ultrasonography, and computed tomography angiography (CTA) findings. Results: Pallor prompted Doppler ultrasonography, followed by CTA; these showed absent right-perforator flow and non-visualisation of that perforator, respectively. The skin did not bleed after puncture. Thermography was performed after these tests and was not taken into account when making the decision about reoperation. IRT demonstrated temperature changes in both skin islands. At 49 h after the initial flap measurement, the mean surface temperature was 26.6 °C in the right skin island and 32.7 °C in the left (absolute difference, 6.1 °C). A focal area of relatively increased surface temperature “hot spot” was identified retrospectively within the viable left skin island; this qualitative observation was exploratory and was not based on a prespecified thermal threshold. Conclusions: Serial IRT was feasible and provided contactless thermal information retrospectively concordant with multimodal perfusion assessment. These findings are hypothesis-generating and do not establish earlier detection, diagnostic accuracy, or a universal thermal threshold; larger prospective studies are required.
Related
- Reconstruction of a fibrous pseudo-patella in total knee arthroplasty after patellectomy: a function-preserving strategy via intraoperative soft tissue balancing and postoperative rehabilitation– a case report
- Sex-Related Differences in Skin Temperature Responses Induced by Small-Sided Games Assessed Using Infrared Thermography.
- Effect of intraoperative tranexamic acid use on postoperative bleeding in tumor replacement surgery : A retrospective cohort study
- The Effects of Intraoperative Hypotension on Postoperative Acute Kidney Injury and Myocardial Injury: A Systematic Review and modelling study
- The impact of intraoperative use of the inhaled anesthetic desflurane on postoperative recovery quality after noncardiac surgery: a meta-analysis of randomized controlled trials
BibTeX
@article{szurko2026serial,
title = {{Serial Static Infrared Thermography for Intraoperative and Postoperative Surface-Temperature Monitoring of Free-Flap Skin Islands in Paediatric Craniofacial Reconstruction: A Technical Feasibility Study}},
author = {Agnieszka Szurko and Zuzanna Sokołowska and Agnieszka Kiełboń and Anna Olejnik and Armand Cholewka and Maciej Borowiec and Tadeusz Morawiec and Michael R. Markiewicz and Martin Starosta and Anna Krzykowska and Krzysztof Dowgierd},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207775},
url = {https://www.mdpi.com/2077-0383/15/20/7775},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Serial Static Infrared Thermography for Intraoperative and Postoperative Surface-Temperature Monitoring of Free-Flap Skin Islands in Paediatric Craniofacial Reconstruction: A Technical Feasibility Study
AU - Agnieszka Szurko
AU - Zuzanna Sokołowska
AU - Agnieszka Kiełboń
AU - Anna Olejnik
AU - Armand Cholewka
AU - Maciej Borowiec
AU - Tadeusz Morawiec
AU - Michael R. Markiewicz
AU - Martin Starosta
AU - Anna Krzykowska
AU - Krzysztof Dowgierd
PY - 2026
DA - 2026/10/09
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207775
UR - https://www.mdpi.com/2077-0383/15/20/7775
AB - Background/Objectives: This single-patient retrospective study evaluated the technical feasibility of serial infrared thermography (IRT) for intraoperative and postoperative surface-temperature documentation of free-flap skin islands and its descriptive concordance with clinical and vascular assessments. Methods: A 9-year-old boy with Nager syndrome undergoing bilateral temporomandibular joint reconstruction and soft-tissue reconstruction with an anterolateral thigh free flap divided into two skin islands was monitored intraoperatively and postoperatively. Thermograms were acquired using a FLIR T1020 camera (emissivity 0.98) under documented environmental conditions. Intraoperative and postoperative observations were interpreted separately, without normalisation between settings. Mean temperatures within manually delineated regions of interest and inter-island differences were analysed retrospectively and compared descriptively with documented clinical assessment, Doppler ultrasonography, and computed tomography angiography (CTA) findings. Results: Pallor prompted Doppler ultrasonography, followed by CTA; these showed absent right-perforator flow and non-visualisation of that perforator, respectively. The skin did not bleed after puncture. Thermography was performed after these tests and was not taken into account when making the decision about reoperation. IRT demonstrated temperature changes in both skin islands. At 49 h after the initial flap measurement, the mean surface temperature was 26.6 °C in the right skin island and 32.7 °C in the left (absolute difference, 6.1 °C). A focal area of relatively increased surface temperature “hot spot” was identified retrospectively within the viable left skin island; this qualitative observation was exploratory and was not based on a prespecified thermal threshold. Conclusions: Serial IRT was feasible and provided contactless thermal information retrospectively concordant with multimodal perfusion assessment. These findings are hypothesis-generating and do not establish earlier detection, diagnostic accuracy, or a universal thermal threshold; larger prospective studies are required.
SN - 2077-0383
ER -