Predicting lipoabdominoplasty complications with infrared thermography: a delta-R analysis

Abstract

The diagnosis of the main complications resulting from lipoabdominoplasty has not yet been standardized. Infrared thermal imaging has been used to assess possible complications, such as necrosis and changes in micro- and macro-circulation, based on perforator mapping techniques, among others. The objective of this study was to present two clinical cases involving thermal imaging monitoring of the healing process of lipoabdominoplasty in the immediate postoperative evaluation and its preliminary results. Infrared thermography was performed 24 hours after the operation and on postoperative days 5, 25, and 27. In clinical case 1, it was found that the delta-R (∆TR)-defined as the difference in minimum temperature between the highest and lowest points in the SA3 region (caution suction area) following the classification established by Matarasso-was 0.4°C at 24 hours after surgery and decreased to 0.1°C on a postoperative day 5. There were no complications in this case. In contrast, in clinical case 2, the ∆TR was 1.7°C at 24 hours after surgery (upon hospital discharge) and remained high, at 2.2°C, on postoperative day 5. A higher ∆TR was found in the second patient, who developed necrosis of the surgical wound. The ∆TR thermal index may be a new tool for predicting possible complications, complementing the clinical evaluation and therapeutic decision-making.

Keywords: Abdominal wall; Abdominoplasty; Lipoabdominoplasty; Postoperative complications; Thermography.

Fig. 1.

Illustration of the anatomical regions (suction areas [SAs]) for lipectomy in abdominoplasty. ARC, arc of skin. Modified from Matarasso. Oper Tech Plast Reconstr Surg 1996;3:7-14 [11].

Fig. 2.

Good postoperative course of lipoabdominoplasty: preoperative and postoperative images. (A) Multispectral thermal images and (B) corresponding photographs. The highest (ROI1) and lowest (ROI2) points in the SA3 region (caution suction area) were selected to calculate the differences in minimum temperatures. In images on the postoperative day 1, ∆T_R=0.4°C. In images on the postoperative day 5, ∆T_R=0.1°C. ROI, region of interest.

Fig. 3.

Poor postoperative course of lipoabdominoplasty: preoperative and postoperative images. (A) Multispectral thermal images and (B) corresponding photography. The highest (ROI1) and lowest (ROI2) points in the SA3 region (caution suction area) were selected to calculate the differences in minimum temperatures. In images on the postoperative day 1, ∆T_R=1.7°C. In images on the postoperative day 5, ∆T_R=2.2°C. ROI, region of interest.

Fig. 4.

Postoperative course of skin dehiscence in case 2. Wound in the infraumbilical region in the area of dermolipectomy, measuring approximately 6×12 cm, with an exudative necrotic background and raised, hyperemic edges. Photographs on (A) postoperative day 25 and (B) postoperative day 27.