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This experimental study compared the direct technique indocyanine green fluorescence angiography (ICG-FA) and the indirect technique dynamic infrared thermography (DIRT) for visualising skin perfusion. Eight isolated human transverse abdominal skin flaps, obtained from female patients undergoing abdominoplasty, were used. A total of 19 selected vessels were individually perfused. Warm and cold perfusate was used for visualising skin perfusion with DIRT. Both techniques were tested for repeatability, making up a total of 34 perfusions. Qualitative analysis of the rate and pattern of perfusion visualised by both techniques was carried out. The extent of the perfused area indicated by the indirect DIRT technique corresponded well with the perfused area indicated by the direct ICG-FA technique. The appearance of distinct hot spots in the IR images provided additional information on the distribution of perforating vessels. It is concluded that in experimental situations the non-invasive DIRT technique is a good alternative to the invasive ICG-FA technique for visualising skin perfusion.

Inadequate perfusion is the most common cause of partial flap loss in reconstructive surgery. Intraoperative monitoring of flap perfusion may prevent such loss. This study compared indocyanine green fluorescence angiography (ICG-FA) and dynamic infrared thermography (DIRT) in their ability to predict intraoperatively the percentage of flap survival in a caudally based McFarlane flap in 10 male Wistar rats. The intraoperative images of both techniques were subjectively and objectively analysed. The percentage of flap survival, as judged from the digital colour photographs 7 days post-operatively, was 69 ± 3%. Objective analysis of flap survival based on intraoperative DIRT and ICG-FA (74 vs 63%, respectively) correlated quite well with the subjective measurements (75 ± 2 vs 59 ± 4%, respectively). However, intraoperative ICG-FA images underestimated flap survival by 6–10%, while intraoperative DIRT images overestimated the flap survival by 5–6%. The authors conclude that intraoperative use of ICG-FA and DIRT can provide valuable information on areas with inadequate perfusion as long as their limitations are respected.

The purpose of the study was to examine the effect of a 12 h period of abstinence from smoking in young and old habitual smokers, on skin rewarming patterns of a hand following local cooling. This was done by comparing changes in peripheral circulation, measured indirectly by monitoring changes in skin surface temperatures of the hand with both infrared (IR) thermography and thermocouples before, during and after immersing the right hand for 2 min in water at 10 degrees C. Included in the study were young male non-smokers (n = 14) and smokers (n = 13), and elderly non-smokers (n = 12) and smokers (n = 14). The results showed no statistically significant difference between young non-smokers and smokers when comparing their response to the local cold challenge. The elderly smokers had a significantly higher hand skin temperature prior to cooling (34.0 +/- 0.2 degrees C) and after 80% rewarming (32.1 +/- 0.2 degrees C) (i.e. when the skin temperature in the "cooled" hand has regained 80% of the cold induced drop in temperature), compared to elderly non-smokers (33.3 +/- 0.2 and 31.3 +/- 0.2 degrees C, respectively). The elderly smoking subjects also had a faster recovery after cooling (9.7 +/- 0.8 min) than the elderly non-smoking subjects (16.7 +/- 2.6 min). A follow-up study with seven elderly smokers, who had smoked as usual until 2 h before the experiment, showed responses lying between the non-smokers and smokers who had had a longer period of abstinence (12 h) from smoking. In conclusion, we have demonstrated using IR-thermal imaging that elderly subjects who have smoked for many years have slightly warmer hand skin temperature when they abstain from smoking. Even a period of abstinence from smoking of a few hours can affect the way in which elderly subjects respond to a local cold challenge, recovering more rapidly then their non-smoking counterparts.

Thermosensitivity (TS) and threshold core temperature for metabolic cold defence were determined in six conscious rabbits before, and at seven different times after i.v. injection of killed Staphylococcus aureus (8 x 10(7) or 2 x 10(7) cell walls x kg(-1)) by exposure to short periods (5-10 min) of body cooling. Heat was extracted with a chronically implanted intravascular heat exchanger. TS was calculated by regression of metabolic heat production (M) and core temperature, as indicated by hypothalamic temperature. Threshold for cold defence (shivering threshold) was calculated as the core temperature at which the thermosensitivity line crossed preinjection resting M. The shivering thresholds followed the shape of the fever response. TS was significantly reduced (up to 49%) during the time course of fever induced by the highest dose of pyrogen only. At both high and low doses of pyrogen TS correlated negatively with shivering threshold (r = 0.66 and 0.79 respectively) with similar slopes. The reduction in TS during fever was thus associated with the increase in shivering threshold resulting from the pyrogen injection and not by the dose of pyrogen. Model considerations indicate, however, that changes in sensitivity of the thermosensory input to the hypothalamic controller may affect threshold changes but cause negligible TS changes. It is more likely that the reduction in TS is effected in the specific hypothalamic effector pathways.

Experiments were performed on conscious goats to confirm the suggestion that in this species the inner body contains more thermosensitive structures than those residing in the hypothalamus and spinal cord. For this purpose goats were chronically implanted with local thermodes and intravascular heat exchangers to allow independent temperature control of the hypothalamus, spinal cord and residual inner body. With the hypothalamus and spinal cord clamped simultaneously at different levels between 32 degrees C and 40 degrees C, residual internal temperature was lowered by subtracting heat via the intravascular heat exchanger. The residual internal temperature at which shivering and increased heat production occured due to heat extraction, was directly related to the value of the combined hypothalamic and spinal cord clamp temperature. The higher hypothalamic and spinal cord clamp temperatures were, the lower residual internal temperature fell before shivering occurred and heat production rose. Plots relating residual internal temperature to hypothalamic and spinal cord temperature at different levels of heat production showed the signal input generated within the residual inner body to be of nearly the same order of magnitude as that from the hypothalamus and spinal cord.

We have investigated how total body thermosensitivity in various mammalian and avian species (mouse, rat, golden hamster, guinea pig, rabbit, dog, goat, pigeon, duck, goose) is related to their respective local thermosensitivities in the hypothalamus, spinal cord and skin. Local and total thermosensitivities were determined by measuring the relationship between the response of one thermoregulatory effector, metabolic heat production, and the appropriate temperature. Local cooling was performed with chronically implanted, water perfused thermodes, and local thermosensitivities were estimated by relating the maximum activation of metabolic heat production to the induced decreases in local temperature. Total body cooling was achieved by means of chronically implanted intravascular heat exchangers or with thermodes inserted into the lower intestinal tract, and total body thermosensitivity was assessed by relating the rise in metabolic heat production to the induced fall in core temperature. These analyses plus previous estimations derived from the literature show total body thermosensitivity in the different species to range from -4.0 to -12.0 W X kg-1 . C-1. We also measured rabbit spinal cord thermosensitivity and guinea pig hypothalamic and spinal cord thermosensitivity; values for local thermosensitivity in other species were derived from the literature. In all species, local thermosensitivities determined as cold sensitivities in the described way were smaller than the corresponding total body core sensitivities. We conclude that thermosensitive structures outside of the investigated thermosensitive areas contribute a major input to the controller of body temperature, particularly in avian species in which hypothalamic thermosensitivity is lacking.(ABSTRACT TRUNCATED AT 250 WORDS)