Infrared thermography-assisted design of the lateral circumflex femoral artery perforator chimeric flap for repairing composite tissue defects in pediatric joints
10.3760/cma.j.cn114453-20240528-00142
- VernacularTitle:红外热成像辅助设计旋股外侧动脉穿支嵌合皮瓣修复儿童关节复合组织缺损
- Author:
Hai LI
1
;
Shun’e XIAO
;
Chengliang DENG
;
Xiangkui WU
;
Bihua WU
;
Zairong WEI
Author Information
1. 遵义医科大学附属医院烧伤整形外科，遵义 563000
- Publication Type:Journal Article
- Keywords:
Surgical flaps;
Perforator flap;
Child;
Infrared thermal imaging
- From:
Chinese Journal of Plastic Surgery
2025;41(4):333-339
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical application value of infrared thermal imaging in assisting the repair of complex joint tissue defects in children using the lateral femoral circumflex artery (LFCA) chimeric perforator flap.Methods:A retrospective analysis was conducted on clinical data from the Department of Burns and Plastic Surgery at the Affiliated Hospital of Zunyi Medical University between May 2019 and September 2023. The study included cases where the LFCA perforator chimeric flap was used to repair complex joint tissue defects in children. Preoperative perforator mapping was performed using an infrared thermal imaging device combined with a portable Doppler. The flap and fascial flap were designed based on the distribution of hot spots and thermal lines. Intraoperative confirmation of perforator distribution was carried out. Postoperative follow-ups were conducted to assess flap survival, the need for secondary thinning procedures, wound healing status, donor site scarring, joint swelling, and functional recovery.Results:A total of 11 pediatric patients were enrolled, including 8 males and 3 females, aged 2 to 14 years (mean age: 5.8 years). The injury mechanisms included traffic accidents (6 cases), wheel spoke injuries (2 cases), falls (2 cases), and heavy object crush injuries (1 case). Affected joints included the wrist (1 case), knee (2 cases), and ankle (8 cases). Associated injuries included metacarpal fracture (1 case), metatarsal fractures (2 cases), and extensor tendon defects (1 case). Tendon defect length was 3 cm, joint capsule defect area ranged from 2 cm × 3 cm to 4 cm × 6 cm, and fascial flap size ranged from 2 cm × 4 cm to 2 cm × 14 cm. Skin defect area ranged from 5 cm × 3 cm to 16 cm × 9 cm, and flap size ranged from 6 cm × 4 cm to 15 cm × 5 cm. Preoperative infrared thermography identified 28 hot spots, with 26 perforators confirmed intraoperatively (positive rate: 92.9%). Thermal line distribution zones consistently corresponded to perforator branches. All 11 flaps survived, with primary healing achieved at both donor and recipient sites. Follow-up duration ranged from 6 to 36 months (mean: 10.5 months). All recipient sites exhibited soft flap texture. One case required secondary debulking due to flap bulkiness. Donor sites showed only linear scarring. During follow-up, no significant joint swelling, functional impairment, or joint dislocation was observed.Conclusion:Infrared thermal imaging-assisted perforator mapping for the design of LFCA chimeric perforator flaps is a safe and reliable method for repairing complex joint tissue defects in children. It provides accurate perforator localization, offering significant clinical value for the design and harvesting of LFCA chimeric perforator flaps in pediatric patients.
