Evaluation of lip myocutaneous flap survival

对3例应用Abbe皮瓣的患者进行了热像图评价。他们在婴儿期或儿童期接受过初级修复。所有患者均于术后第14天将Abbe皮瓣置入上唇中部，分离血管蒂，术后3d复温，分离后复冷2d。术后4~5天，皮瓣远端或近端温度较周围正常皮肤温度下降1.1~2.0ﾟ℃。分离皮瓣后，中远端温度再次下降1~3.7ﾟ℃，持续2天。由于降温时临床上可见皮瓣紫紫、水肿，热像图不仅有助于判断皮瓣存活，而且可客观、定量地分析创面愈合过程。用激光多普勒血流仪测定皮瓣局部及周围正常皮肤的微循环，术后即刻微循环减少，术后第1天逐渐增加。并在一周内恢复到周围正常皮肤水平。

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.