Evaluation of lip myocutaneous flap survival

对3例阿贝瓣患者进行了红外热像评价。他们在婴儿期或儿童期接受过初次修复。所有患者均于术后第14天将Abbe瓣置入上唇中部，分离血管蒂，术后第3天热像显示皮瓣呈冷态，分离后第2天再次呈冷态。术后4 ~ 5天，皮瓣远端或近端的温度与周围正常皮肤相比下降了1.1 ~ 2.0 ℃。皮瓣分离后，皮瓣中、远端温度再次下降1.0-3.7 ℃，持续2天。热像图不仅可用于判断皮瓣成活，而且可用于客观定量分析创面愈合过程。应用激光多普勒血流仪测定皮瓣及周围正常皮肤的血细胞流速，术后即刻Abbe皮瓣尖端微循环下降，术后第1天逐渐恢复，一周后与周围正常皮肤水平接近。

Thermographic evaluation was made on three patients with Abbe flap. They had recieved primary repairs in infancy or childhood. The Abbe flap was inserted into the middle of the upper lip, and the vascular pedicle was separated on the 14th postoperative day in all patients.Thermographically the flap was cold for 3 postoperative days and became cold again for 2 days after the flap was separated. The temperature of the distal or proximal portion of the flap fell 1.1 to 2.0ﾟC during four or five postoperative days compared with those of the surrounding normal skin. After the flap was separated, the temperatures of the flap again fell 1.0-3.7ﾟC for 2 days at the middle and distal portion.Since cyanosis and edema were clinically noticed in the flap when there was a fall in temperature, thermography was considered to be useful not only for judgment of flap survival but also for objective and quantitative analyzes of the wound healing process.The microcirculation of flap was measured at few points of flap and surrounding normal skin by laser doppler flowmetry for blood cell velocity determination.The microcirculation at the tip of Abbe flap decreased immediately after operation, increased gradually on first postoperative day, and was at the surrounding normal skin level in a week.