Thermography of hands after a radial forearm flap has been harvested

Abstract

To determine the change of blood flow in the hand after radial forearm flap harvest, several studies using thermography or color Doppler ultrasonography have been reported (Iida et al., Ann Plast Surg 49:156, 2002; Suominen and Asko-Seljavaara, Scand J Plast Reconstr Hand Surg 30:307, 1996). One study using Doppler ultrasonography (Iida et al., Ann Plast Surg 49:156, 2002) found reduced blood flow, while another study using thermography (Suominen and Asko-Seljavaara, Scand J Plast Reconstr Hand Surg 30:307, 1996) reported warm digits. However, the thermographic study did not examine the postoperative period. We evaluated temperature changes by thermography during three different postoperative periods: 3, 6, and 12 months. Differences in temperature were measured between the donor hand and the other hand in the resting state and after cold stress at the thenar eminence. The differences in temperature were divided into three grades. The donor hand was classified as being warmer, similar, or cooler than the other hand. There was a tendency for cold stress to accentuate differences in temperature. After cold stress, the percentage for warmer was 75.0% at 3 months, while similar increased to 87.5% at 6 and 12 months. The temperature of the donor hand increased for a limited period after surgery for up to 3 months, and the temperature of the donor hand became similar to that of the nondonor hand. Therefore, circulatory changes in the hand undergoing flap harvest are thought to be minimal. Considering other reports, we think the high temperature at the thenar eminence of the donor hand shortly after surgery is partially explained by sympathetic nerve damage.