IMPROVEMENT OF THE DERMATENSION METHOD IN THE RECONSTRUCTIVE-RECOVERY SURGERY OF DEFECTS OF SOFT TISSUES OF VARIOUS...

Area of Science:

• Reconstructive Surgery
• Tissue Engineering
• Medical Imaging

Background:

• Treating skin loss and complex wounds remains a clinical challenge.
• Dermatension, while technically simple, risks flap decubitus due to vascular compression from excessive fluid.
• Preventing circulatory disturbances in stretched tissues is crucial for successful reconstruction.

Purpose of the Study:

• To enhance the dermatension method in reconstructive surgery for soft tissue defects.
• To integrate ultrasound and infrared thermography (ICT) for instrumental process control.
• To improve planning and execution of dermatension through real-time monitoring.

Main Methods:

• Surgical treatment of scalp defects using dermatension for plastic material.
• Utilized ultrasound to measure flap thickness and ICT for blood circulation assessment.
• Implemented a two-stage dermatension process with continuous monitoring and fluid adjustment based on flap perfusion indicators.

Main Results:

• Ultrasound and ICT provided accurate assessment of flap thickness and perfusion dynamics.
• Monitoring flap temperature reduction (over 10°C) indicated compromised circulation, guiding fluid evacuation.
• The integrated approach allowed for precise control during all dermatension stages, from planning to completion.

Conclusions:

• Combined ultrasound and ICT monitoring significantly improves the assessment of blood circulation (perfusion) in stretched flaps.
• This method enhances the planning and execution of dermatension, enabling proactive prevention of ischemia, decubitus, and necrosis.
• The improved dermatension technique offers a more reliable solution for soft tissue reconstruction in complex wound cases.