Abstract ID: 26-206
Smartphone-based thermal imaging in periocular flap surgery: category-specific gradients and candidate early markers for postoperative complications
Author: Nataliia Mala Base Hospital / Institution: University Hospital Muenster
Presentation Type: ePoster Presentation
Purpose
Smartphone-based thermal imaging (SBTI) has been proposed as an adjunct for perfusion assessment of pedicled flaps. We extend the method to the anatomically distinct periocular region and test whether the previously reported thermographic predictor transfers.
Methods
Prospective observational study of 30 periocular flaps in four complexity categories: very small (n=4), classical (n=14), large (n=8), and deep posterior-lamella reconstructions (Hughes/periosteal, n=4). A smartphone-attached infrared camera (FLIR-One) recorded mean surface temperatures of the flap, the immediate periflap border and an adjacent non-flap reference area. Gradients between these zones were analysed after flap elevation, after suturing, after placing the full-thickness graft onto the deep flap (timepoint for category 4), and 24h postoperatively. Non-parametric tests, Spearman correlations with FDR correction, and univariate logistic regression were used.
Results
Three of 30 flaps (10%) developed a complication. The predictor previously reported as strongest — the flap-to-reference gradient after suturing — did not replicate (p=0.566). The most informative signal emerged directly after flap elevation: complication cases showed an elevated gradient between the periflap border and the reference skin (median 1.5 vs. 0.4°C; p=0.086; odds ratio 9.3). Gradients depended strongly on flap size: large flaps produced much larger differences than small or classical ones (up to 3.1 vs. ≤1.1°C; p<0.01) yet developed no complication. Over 24h, uneventful flaps warmed by median 2.2°C versus only 0.6°C in complications.
Conclusion
Published thresholds do not transfer universally to the periocular region. Small and classical periocular flaps show much smaller baseline gradients than large ones, so even modest deviations may be prognostically relevant and warrant category-specific cutoffs. An elevated border-zone gradient after elevation and limited 24h flap warming emerge as candidate early markers identifying cases for closer postoperative follow-up. SBTI is a simple smartphone-based adjunct to surgical judgement.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Lukas | Fiedler | SLK-Kliniken Heilbronn |