A method and device for monitoring blood flow after flap transfer surgery

Abstract

This invention discloses a method and device for monitoring blood supply after flap transfer, belonging to the field of postoperative nursing observation. The method includes: acquiring multiple first temperature values ​​corresponding to multiple first points in a first region of the free flap transferred to the recipient area, and calculating the average first temperature T1; acquiring multiple second temperature values ​​corresponding to multiple second points in a second region of the free flap transferred to the recipient area, and calculating the average second temperature T2; acquiring multiple third temperature values ​​corresponding to multiple third points in a normal skin region near the free flap transferred to the recipient area, and calculating the average third temperature T3; and executing a preset alarm prompting strategy based on the relationship between the average first temperature T1, the average second temperature T2, and the average third temperature T3. This invention can improve the consistency of assessing the postoperative flap blood supply status and also improve the sensitivity of identifying blood supply disorders.

Description

Technical Field

[0001] This invention relates to the field of postoperative nursing observation technology, and in particular to a method and device for monitoring blood circulation after flap transfer. Background Technology

[0002] In existing technologies, postoperative blood supply monitoring and data recording after flap transfer are generally performed by professional nurses. This process is highly subjective and requires the personal intervention of professional nurses, resulting in significant differences in the data recorded by different professional nurses. Furthermore, the efficiency of monitoring and recording is limited, making it impossible to perform monitoring and recording more frequently. Consequently, it is difficult to detect signs of vascular crisis earlier, which poses a challenge to postoperative recovery.

[0003] In response, related technologies have proposed solutions to improve the automation of blood supply monitoring and data recording after flap transfer using monitoring instruments. For example, Patent Document 1 discloses an infrared remote monitoring method for blood supply in tissue flaps. This method sets multiple temperature data acquisition points on the tissue flap and acquires multiple sets of sample temperature values ​​in real time; it also sets multiple temperature data acquisition points on the normal skin near the tissue flap and acquires multiple sets of control temperature values ​​in real time. When the difference between the average sample temperature and the average control temperature exceeds a certain range, it indicates that the tissue flap may have a blood supply disorder, and the host computer issues an alarm. This solution determines the blood supply status of the flap by comparing the difference between the average sample temperature on the flap and the average control temperature on the nearby normal skin. For example, when the difference is greater than 3°C, a vascular crisis alarm is issued, which can effectively improve the monitoring efficiency, accuracy, and reliability of blood supply in tissue flaps.

[0004] However, the above solution still has the following shortcomings:

[0005] 1. The collection points selected on the flap cannot be determined for different patients. When determining the collection points on the flap for different patients, the operator's subjective perception is still the main factor in selecting the collection points, resulting in poor consistency in assessing the blood supply status of the flap after surgery.

[0006] 2. When the temperature difference between the skin flap and the surrounding normal skin exceeds the threshold, it indicates that the overall blood supply to the skin flap is severely impaired. The above method can only reflect that the blood supply to the skin flap has deteriorated considerably compared to the surrounding normal skin, but it cannot reflect the blood supply to the skin flap itself before the deterioration, thus making it impossible to detect signs of blood pressure disorders earlier.

[0007] Patent Document 1, Patent Title: Method and Instrument for Remote Infrared Monitoring of Blood Supply in Tissue Flaps; Publication Number: CN113425267A; Publication Date: 2021-09-24. Summary of the Invention

[0008] The object of the present invention is to solve at least one of the technical problems existing in the prior art, and to provide a method for monitoring blood circulation after skin flap transfer. The positions of each collection point in the skin flap are clearly defined in advance for each patient, which can improve the consistency of evaluating the blood circulation status of the skin flap after surgery, and can also reflect the deterioration signs of the blood circulation status of the skin flap earlier based on the temperature difference in different regions inside the skin flap, and improve the sensitivity of identifying blood circulation disorders.

[0009] In order to achieve the above object of the invention, the present invention provides the following technical solutions:

[0010] In the first aspect, the present invention provides a method for monitoring blood circulation after skin flap transfer, and the method includes:

[0011] Obtain a plurality of first temperature values corresponding to a plurality of first points in a first region of the free skin flap transferred to the recipient area, and calculate the first temperature mean value T1; wherein, the first region is the region corresponding to the target blood vessel walking region on the surface of the free skin flap transferred to the recipient area; the target blood vessel is the blood vessel anastomosed with the blood supply vessel of the recipient area;

[0012] Obtain a plurality of second temperature values corresponding to a plurality of second points in a second region of the free skin flap transferred to the recipient area, and calculate the second temperature mean value T2; wherein, the second region is the other region of the free skin flap transferred to the recipient area except the first region;

[0013] Obtain a plurality of third temperature values corresponding to a plurality of third points in the normal skin region near the free skin flap transferred to the recipient area, and calculate the third temperature mean value T3;

[0014] Based on the relationship among the first temperature mean value T1, the second temperature mean value T2, and the third temperature mean value T3, execute a preset alarm prompt strategy; wherein, the preset alarm prompt strategy includes: if T1 < T2 < T3 and T3 - (T1 + T2) / 2 < θ, then issue a first-level alarm prompt for blood circulation disorder; if T3 - (T1 + T2) / 2 ≥ θ, then issue a second-level alarm prompt for blood circulation disorder; if T1 > T3, or T2 > T3, then issue an infection and inflammation alarm prompt; θ is a preset temperature difference threshold.

[0015] As a further improvement, the method further includes:

[0016] At each preset monitoring time node, use the infrared thermal imaging lens of the imaging device to take an infrared thermal image of the recipient area including the free skin flap and the nearby normal skin;

[0017] The specific process of obtaining a plurality of first temperature values corresponding to a plurality of first points in the first region of the free skin flap transferred to the recipient area includes:

[0018] Based on a preset first coordinate set, multiple first temperature values ​​corresponding to multiple first points in the first region are obtained from the infrared thermal image of the receiving area; wherein, the coordinates in the first coordinate set are used to define the boundary of the first region;

[0019] The acquisition of multiple second temperature values ​​corresponding to multiple second points in the second region of the free flap transferred to the recipient area specifically includes:

[0020] Based on a preset first coordinate set and a second coordinate set, multiple second temperature values ​​corresponding to multiple second points in the second region are obtained from the infrared thermal image of the receiving region; wherein, the coordinates in the second coordinate set are used to define the boundary of the free flap transferred to the receiving region;

[0021] The acquisition of multiple third temperature values ​​corresponding to multiple third points in the normal skin area near the free flap transferred to the recipient area specifically includes:

[0022] Based on a preset second coordinate set, multiple third temperature values ​​corresponding to multiple third points in the normal skin area near the free flap transferred to the recipient area are obtained from the infrared thermal image of the recipient area.

[0023] As a further improvement, the imaging device is equipped with both a visible light lens and an infrared thermal imaging lens, and the first coordinate set and the second coordinate set are obtained through the following process:

[0024] While the flap is still in the donor area and in the pedicled flap state, and with the imaging device in the first posture, a visible light image of the first donor area containing the pedicled flap is captured using a visible light lens, and an infrared thermal image of the donor area containing the pedicled flap is captured using an infrared thermal imaging lens.

[0025] Based on the first mapping relationship between the visible light lens and the infrared thermal imaging lens, the visible light image of the first supply area and the infrared thermal image of the supply area are determined. Figure 2 The second mapping relationship of the image coordinate system;

[0026] The course of the target blood vessel in the infrared thermal image of the donor area is determined based on the target high-temperature region connected to the pedicle in the infrared thermal image of the donor area.

[0027] Based on the course region of the target blood vessel in the infrared thermal image of the donor area and the second mapping relationship, the course region of the target blood vessel in the visible light image of the first donor area is determined.

[0028] With the imaging device in the first position, a visible light image of the second donor area, including the pedicled flap and multiple marker points, is captured using a visible light lens; wherein, the multiple marker points are drawn on the surface of the pedicled flap in the region corresponding to the course of the target blood vessel, with reference to the first visible light image;

[0029] After the flap becomes a free flap transferred to the recipient area, and with the imaging device in the second posture, a visible light image of the recipient area containing the free flap, multiple markers and nearby normal skin is captured using a visible light lens, and an infrared thermal image of the recipient area containing the free flap, multiple markers and nearby normal skin is captured using an infrared thermal imaging lens.

[0030] Based on the multiple point pairs formed by the multiple marker points in the second supply area visible light image and the receiving area visible light image respectively, a third mapping relationship between the image coordinate systems of the second supply area visible light image and the receiving area visible light image is obtained;

[0031] Based on the first mapping relationship, the second mapping relationship and the third mapping relationship, a set of coordinates corresponding to the contour of the target blood vessel in the infrared thermal image of the donor area are transformed to the coordinate system of the infrared thermal image of the recipient area, and the first coordinate set is constructed with the set of coordinates transformed to the coordinate system of the infrared thermal image of the recipient area.

[0032] The second coordinate set is constructed based on a set of coordinates corresponding to the edge contour of the free flap transferred to the receiving area in the infrared thermal image of the receiving area.

[0033] As a further improvement, points on the infrared thermal image of the supply area where the temperature difference with the stem does not exceed a preset second temperature difference threshold are defined as high-temperature points. All points in the high-temperature area are considered high-temperature points. The target high-temperature area connected to the stem refers to a path that must be a high-temperature path from any high-temperature point in the target high-temperature area to the stem. The high-temperature path refers to a path through which all points are high-temperature points.

[0034] As a further improvement, when the infrared thermal imaging lens of the imaging device is used to take pictures to obtain the infrared thermal image of the receiving area at each preset monitoring time node, a positioning auxiliary frame is displayed on the shooting interface. The positioning auxiliary frame includes an inner frame and an outer frame. The outline of the inner frame is defined by a first coordinate set, and the outline of the outer frame is defined by a second coordinate set.

[0035] As a further improvement, when entering the shooting interface for the n+1th time at the preset monitoring time node, the current posture of the imaging device is identified based on the posture sensor. If the current posture of the imaging device is identified to be different from the posture during the nth shooting, a posture guidance control is displayed on the shooting interface. The posture guidance control is used to display the difference between the current posture of the imaging device and the posture during the nth shooting in real time, as well as the adjustment direction and adjustment amount of the difference.

[0036] As a further improvement, the method also includes:

[0037] If, among the (m+1) monitoring results from the nmth monitoring result to the nth monitoring result, the average first temperature value corresponding to each monitoring result shows a decreasing or increasing trend, and T1>T2 and T3-(T1+T2) / 2<θ, then the monitoring time node t_(n+1) of the (n+1)th monitoring result is adjusted as follows:

[0038] t_(n+1)=t_(n)+α*△t; where n and m are positive integers, and m<n; α is a correction coefficient, △t is the preset time interval between two adjacent monitoring time nodes; t_(n) is the nth monitoring time node, 1 / 3≤α≤3 / 4.

[0039] As a further improvement, the method also includes:

[0040] At each preset monitoring time point, a visible light image of the receiving area, including the free skin flap and the surrounding normal skin, is captured using the visible light lens of the imaging device;

[0041] The color of the free flap in the visible light image of the receiving area is compared with preset skin color data in the database;

[0042] Based on the comparison results, the skin color score corresponding to the free flap was determined.

[0043] In a second aspect, the present invention provides a computer-readable storage medium storing computer-executable instructions for causing a computer to perform the steps of the above-described method.

[0044] Thirdly, the present invention provides a blood supply monitoring device after flap transfer surgery, comprising: a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor executes the steps of the above method when executing the program.

[0045] Beneficial effects:

[0046] Existing technologies, such as those described in Patent Document 1, only issue a vascular crisis alarm (i.e., the secondary alarm of this invention) when the temperature of the skin flap is 3 degrees Celsius lower than the temperature of the surrounding normal skin. At this point, the vascular obstruction may already be quite deep, leading to delayed intervention. In this invention, a primary alarm can be triggered before the secondary alarm. By comparing the temperature difference between the target blood vessel area and the non-target blood vessel area within the skin flap, signs of blood supply obstruction in the flap can be detected earlier. This is because the temperature of the blood vessel area is higher than the surrounding area, especially for free flaps where the target blood vessel is connected to the blood supply vessels of the recipient area, resulting in a higher temperature within the free flap compared to other areas. If the temperature of the target blood vessel area is lower than the temperature of other areas within the free flap, it indicates a possible obstruction in the blood supply of the target blood vessel, triggering a primary alarm. This prompts the physician to conduct a more detailed observation of the flap's blood supply, such as capillary filling, at an earlier stage. Therefore, this invention can detect earlier signs of blood supply obstruction before the secondary alarm occurs, improving the sensitivity of blood supply obstruction identification. Furthermore, in this embodiment, unlike in Reference 1 where the selection of collection points for different patients is mainly influenced by the operator, this embodiment clearly defines the location of each collection point in the flap in advance for each patient, which can improve the consistency of assessing the postoperative blood supply status of the flap.

[0047] Additional aspects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. Attached Figure Description

[0048] The present invention will be further described below with reference to the accompanying drawings and embodiments;

[0049] Figure 1 This is a flowchart illustrating a method for monitoring blood supply after flap transfer in one embodiment;

[0050] Figure 2 This is a flowchart illustrating the process of determining the first coordinate set and the second coordinate set in one embodiment;

[0051] Figure 3 This is a flowchart illustrating a method for monitoring blood supply after flap transfer in yet another embodiment;

[0052] Figure 4 This is a schematic diagram illustrating the principle of determining the first coordinate set and the second coordinate set in one embodiment;

[0053] Figure 5 This is a schematic diagram illustrating the principle of adjusting the orientation of an imaging device in one embodiment. Detailed Implementation

[0054] This section will describe in detail specific embodiments of the present invention. Preferred embodiments of the present invention are shown in the accompanying drawings, which are used to supplement the description in the text part of the specification, enabling people to intuitively and vividly understand each technical feature and the overall technical solution of the present invention. However, it should not be construed as a limitation on the protection scope of the present invention.

[0055] As Figure 1 shown, in one embodiment, a method for monitoring blood circulation after flap transfer is provided. The method includes:

[0056] Step S202: Obtain multiple first temperature values corresponding to multiple first points in a first region of the free flap transferred to the recipient area, and calculate the first temperature average value T1. Here, the first region is the region corresponding to the target blood vessel running area on the surface of the free flap transferred to the recipient area; the target blood vessel is the blood vessel anastomosed with the blood supply vessel of the recipient area.

[0057] Step S204: Obtain multiple second temperature values corresponding to multiple second points in a second region of the free flap transferred to the recipient area, and calculate the second temperature average value T2. Here, the second region is the other region on the surface of the free flap transferred to the recipient area except the first region.

[0058] Step S206: Obtain multiple third temperature values corresponding to multiple third points in the normal skin area near the free flap transferred to the recipient area, and calculate the third temperature average value T3.

[0059] Step S208: Based on the relationship among the first temperature average value T1, the second temperature average value T2, and the third temperature average value T3, execute a preset alarm prompt strategy. Here, the preset alarm prompt strategy includes: if T1 < T2 < T3 and T3 - (T1 + T2) / 2 < θ, issue a first-level alarm prompt for blood circulation disorder; if T3 - (T1 + T2) / 2 ≥ θ, issue a second-level alarm prompt for blood circulation disorder; if T1 > T3 or T2 > T3, issue an alarm prompt for infection and inflammation; θ is a preset temperature difference threshold.

[0060] Understandably, existing technologies, such as those in Patent Document 1, require the flap temperature to be 3 degrees Celsius lower than the surrounding normal skin temperature before a vascular crisis alarm (i.e., the secondary alarm in this embodiment) can be triggered. At this point, the vascular obstruction may already be quite deep, leading to delayed intervention. In this embodiment, however, a primary alarm can be triggered before the secondary alarm. By comparing the temperature difference between the target vessel's course area and non-target vessel's course area within the flap, signs of flap blood supply obstruction can be detected earlier. This is because the temperature of the vessel's course area is higher than the surrounding area, especially for free flaps where the target vessel is connected to the blood supply vessel of the recipient area, resulting in a higher temperature within the free flap compared to other areas. If the temperature of the target vessel's course area is lower than the temperature of other areas within the free flap, it indicates a possible obstruction in the target vessel's blood supply, triggering a primary alarm. This allows the physician to conduct a more detailed observation of the flap's blood supply, such as capillary filling, at an earlier stage. Therefore, this embodiment can detect earlier signs of blood supply obstruction before the secondary alarm occurs, improving the sensitivity of blood supply obstruction identification. Furthermore, in this embodiment, unlike in Reference 1 where the selection of collection points for different patients is mainly influenced by the operator, this embodiment clearly defines the location of each collection point in the flap in advance for each patient, which can improve the consistency of assessing the postoperative blood supply status of the flap.

[0061] As a further improvement, the method also includes:

[0062] At each preset monitoring time point, the infrared thermal imaging lens of the imaging device is used to capture an infrared thermal image of the affected area, including the free skin flap and the surrounding normal skin.

[0063] The acquisition of multiple first temperature values ​​corresponding to multiple first points in the first region of the free flap transferred to the recipient area specifically includes:

[0064] Based on a preset first coordinate set, multiple first temperature values ​​corresponding to multiple first points in the first region are obtained from the infrared thermal image of the receiving area; wherein, the coordinates in the first coordinate set are used to define the boundary of the first region.

[0065] For example, assuming the number of first points to be selected is predetermined to be 10, 10 coordinate points can be randomly selected from the first region as the corresponding first points. Each coordinate point in the infrared thermal image corresponds to a temperature value. Therefore, based on the coordinate points corresponding to the first points, the first temperature value corresponding to each coordinate point is obtained from the infrared thermal image of the receiving area, and the average of the 10 first temperature values ​​is calculated to obtain the first temperature average T1.

[0066] The acquisition of multiple second temperature values ​​corresponding to multiple second points in the second region of the free flap transferred to the recipient area specifically includes:

[0067] Based on a preset first coordinate set and a second coordinate set, multiple second temperature values ​​corresponding to multiple second points in the second region are obtained from the infrared thermal image of the receiving region; wherein, the coordinates in the second coordinate set are used to define the boundary of the free flap transferred to the receiving region.

[0068] For example, assuming the number of second points to be selected is predetermined to be 10, 10 coordinate points can be randomly selected from the second region as the corresponding second points. Each coordinate point in the infrared thermal image corresponds to a temperature value. Therefore, based on the coordinate points corresponding to the second points, the second temperature values ​​corresponding to each coordinate point are obtained from the infrared thermal image of the receiving area, and the average of the 10 second temperature values ​​is calculated to obtain the average second temperature T2.

[0069] The acquisition of multiple third temperature values ​​corresponding to multiple third points in the normal skin area near the free flap transferred to the recipient area specifically includes:

[0070] Based on a preset second coordinate set, multiple third temperature values ​​corresponding to multiple third points in the normal skin area near the free flap transferred to the recipient area are obtained from the infrared thermal image of the recipient area.

[0071] For example, the portion of the infrared thermogram of the receiving area outside the second region belongs to the normal skin area near the free flap. Therefore, assuming that the number of third points to be selected is predetermined to be 10, 10 coordinate points can be randomly selected from the normal skin area near the free flap as the corresponding third points. Each coordinate point in the infrared thermogram corresponds to a temperature value. Therefore, based on the coordinate points corresponding to the third points, the third temperature value corresponding to each coordinate point is obtained from the infrared thermogram of the receiving area, and the average of the 10 third temperature values ​​is calculated to obtain the average third temperature T3.

[0072] In this embodiment, at each preset monitoring time point, an infrared thermal imaging lens is used to capture an infrared thermal image containing the free flap and the surrounding normal skin. Based on the preset first coordinate set and second coordinate set, the temperature of multiple points in the three regions of the flap (first region, second region, and surrounding normal skin region) can be automatically obtained from the infrared thermal image. This eliminates the need for manual selection of each point and temperature collection point by point, improving the efficiency of temperature collection at each point and enhancing the consistency of assessing the postoperative blood supply status of the flap.

[0073] In one embodiment, the imaging device is equipped with both a visible light lens and an infrared thermal imaging lens, such as... Figure 2 and Figure 4 As shown, the first coordinate set and the second coordinate set are obtained through the following process:

[0074] Step S301: While the flap is still located in the donor area and in the pedicled flap state, and with the imaging device in the first posture, a visible light image B of the first donor area containing the pedicled flap 21 is captured using a visible light lens, and an infrared thermal image A of the donor area containing the pedicled flap 21 is captured using an infrared thermal imaging lens.

[0075] like Figure 4 As shown, in the donor site infrared thermogram A, the outline of the pedicled flap 21 is relatively dark, while the area corresponding to the target blood vessel 23 (i.e., the part shown by the dashed line in the donor site infrared thermogram A), i.e., the first region 24, is brighter. The black square in the donor site infrared thermogram A represents the pedicle 22, which is located at the intersection of the outline of the first region 24 and the pedicled flap 21. Its position is marked by the doctor in the donor site infrared thermogram A. Referring to the first donor site visible light image B, only the outline of the pedicled flap 21 is visible in the visible light image, and the area corresponding to the target blood vessel 23 is not visible.

[0076] Step S302: Based on the first mapping relationship between the visible light lens and the infrared thermal imaging lens, determine the visible light image of the first supply area and the infrared thermal image of the supply area. Figure 2 The second mapping relationship of the image coordinate system.

[0077] There is a definite transformation relationship between the camera coordinate system corresponding to the visible light lens and the image coordinate system corresponding to the first supply area visible light image B, and there is also a definite transformation relationship between the camera coordinate system corresponding to the infrared thermal imaging lens and the image coordinate system corresponding to the supply area infrared thermal image A. Since the first mapping relationship between the visible light lens and the infrared thermal imaging lens installed on the same imaging device can be obtained through calibration, the second mapping relationship between the image coordinate systems of the first supply area visible light image B and the supply area infrared thermal image A can be obtained based on the above three transformation relationships (i.e., mapping relationships). The calibration between two lenses with a common field of view and the transformation relationship between the two image coordinate systems are existing technologies and will not be elaborated here.

[0078] Step S303: Determine the course of the target blood vessel in the infrared thermal image of the donor area based on the target high-temperature region connected to the pedicle in the infrared thermal image of the donor area.

[0079] Specifically, points on the infrared thermal image of the supply area where the temperature difference with the stem does not exceed a preset second temperature difference threshold are defined as high-temperature points, and all points in the high-temperature area are high-temperature points; the target high-temperature area connected to the stem means that there must be a high-temperature path among the paths taken from any high-temperature point in the target high-temperature area to the stem; wherein, the high-temperature path means that all points passed along the path are high-temperature points.

[0080] like Figure 4 As shown in the infrared thermogram A of the donor area, assuming the preset second temperature difference threshold is 0.5℃, the point with a temperature difference of no more than 0.5℃ from the pedicle 22 and that the point can reach the pedicle 22 through a high temperature path, and that the point is located within the area enclosed by the outline of the pedicle flap 21, and that the point belongs to the course area of ​​the target blood vessel. Specifically, the two ends of the unclosed outline of the pedicled flap 21 on the infrared thermal image A of the donor area can be connected with a straight line to obtain a closed area enclosed by the outline of the pedicled flap 21. Then, starting from the coordinate point corresponding to the pedicle 22 within this closed area, all high-temperature points adjacent to the coordinate point of the pedicle 22 are checked one by one to obtain the first batch of high-temperature points. Then, all new high-temperature points adjacent to the first batch of high-temperature points are checked one by one to obtain the second batch of high-temperature points. And so on, the nth batch of high-temperature points can be obtained until all coordinate points (i.e., points) adjacent to the nth batch of high-temperature points are no longer high-temperature points. These n batches of high-temperature points together constitute the target high-temperature area mentioned above. Then, a copy of the infrared thermal image A of the donor area is made, and the pixel values ​​of the coordinate points corresponding to the n batches of high-temperature points in the copied infrared thermal image A are all set to 1 (that is, the pixel values ​​of the target high-temperature area are all set to 1), while all other positions are set to 0. Based on the contour extraction algorithm, the coordinate set of the contour (i.e. the boundary) corresponding to the target high-temperature area in the coordinate system of the infrared thermal image A of the donor area is obtained, which is the first coordinate set. The first coordinate set is used to define the course area of ​​the target blood vessel 23 in the infrared thermal image A of the donor area.

[0081] It should be noted that the trajectory of the target blood vessel 23 is continuous. Using the above method, the course area corresponding to the target blood vessel 23 can be accurately captured.

[0082] Step S304: Based on the course region of the target blood vessel in the infrared thermal image A of the donor area and the second mapping relationship, determine the course region of the target blood vessel in the visible light image B of the first donor area.

[0083] Specifically, in step S303, the set of contour coordinates corresponding to the target blood vessel 23 in the donor area infrared thermograph A, i.e., the first region 24, has been obtained. Therefore, by transforming the second mapping relationship between the image coordinate systems of the first donor area visible light image B and the donor area infrared thermograph A, the target blood vessel 23's course can be determined in the first donor area visible light image B. Through image processing technology, the contour corresponding to the target blood vessel 23's course can be displayed on the first donor area visible light image B, facilitating the doctor to draw multiple marker points 25 on the pedicled flap surface in the region corresponding to the target blood vessel's course, referring to the first donor area visible light image B. It is understood that the number of marker points 25 can be 3 or 4, using a marker pen to draw 3 or 4 marker points 25 of different shapes, facilitating feature detection operations in subsequent image registration algorithms.

[0084] Step S305: With the imaging device in the first posture, a second donor area visible light image C containing the pedicled flap 21 and multiple marker points 25 is captured using a visible light lens; wherein, the multiple marker points 25 are drawn on the surface of the pedicled flap 21 in the area corresponding to the course of the target blood vessel 23 with reference to the first visible light image B.

[0085] Step S306: After the flap becomes a free flap 26 transferred to the recipient area, and with the imaging device in the second posture, a visible light image D of the recipient area containing the free flap 26, multiple marker points 25 and nearby normal skin is captured using a visible light lens, and an infrared thermal image E of the recipient area containing the free flap 26, multiple marker points 25 and nearby normal skin is captured using an infrared thermal imaging lens.

[0086] It should be noted that multiple marker points 25 cannot be clearly observed in the infrared thermal image E of the received area, but can be clearly identified in the visible light image D of the received area.

[0087] Step S307: Based on the multiple point pairs formed by the multiple marker points in the second supply area visible light image C and the receiving area visible light image D respectively, a third mapping relationship between the image coordinate systems of the second supply area visible light image C and the receiving area visible light image D is obtained.

[0088] Specifically, a general image registration algorithm can be used to register the second donor area visible light image C and the recipient area visible light image D. Because the free flap 26 needs to be sutured to the recipient area, its contour differs from that of the pedicled flap 21. Therefore, in this embodiment, it is only necessary to determine the position of the target vessel 23 in the recipient area visible light image D, without needing to consider whether the flap edge contours are aligned.

[0089] Step S308: Based on the first mapping relationship, the second mapping relationship, and the third mapping relationship, a set of coordinates (i.e., the first coordinate set) corresponding to the contour of the target blood vessel 23 in the donor area infrared thermal image A is transformed to the coordinate system of the recipient area infrared thermal image E, and the first coordinate set is constructed using the set of coordinates transformed to the coordinate system of the recipient area infrared thermal image E.

[0090] like Figure 4 As shown in the infrared thermal image E of the received area, the outline corresponding to the first region 24 is displayed in the infrared thermal image E of the received area based on the first coordinate set.

[0091] Step S309: Construct the second coordinate set based on a set of coordinates corresponding to the edge contour of the free flap 26 transferred to the receiving area in the infrared thermal image E of the receiving area.

[0092] like Figure 4 As shown in the received-area infrared thermal image E, the edge brightness of the free flap 26 is the lowest in received-area infrared thermal image E. Based on the contour extraction algorithm, a set of coordinates corresponding to the edge contour of the free flap 26 can be extracted, and this set of coordinates is used to construct the second coordinate set. Specifically, when multiple coordinate sets corresponding to contours are extracted from the received-area infrared thermal image E, the coordinate set that intersects with the first coordinate set and has the most corresponding coordinates is selected as the second coordinate set. This method can eliminate the interference of other small contours. In one example, contour detection functions (such as findContours) in the OpenCV image processing library can be used for contour detection, returning a list where each element represents a contour in the image. Each contour itself is a set of coordinate points representing the boundary of the contour.

[0093] Understandably, when the flap is transferred to the recipient area, the target blood vessel has not yet returned to its normal state, making it impossible to determine the course of the target blood vessel using the infrared thermograph of the recipient area. Furthermore, after the flap is transferred to the recipient area, it is sutured there, resulting in a slight difference in appearance between the free flap 26 transferred to the recipient area and the pedicled flap 21 in the donor area. Therefore, it is impossible to determine the course of the target blood vessel in the recipient area's visible light image by comparing the appearance of the recipient area and the donor area's visible light images. Thus, the course of the target blood vessel 23 in the recipient area's infrared thermograph E cannot be determined solely by the infrared thermograph. Steps S301 to S309 provided in this embodiment are needed to determine the course of the target blood vessel 23 in the recipient area's infrared thermograph E, in order to monitor the first temperature value of the target blood vessel 23's course and achieve more precise postoperative observation.

[0094] like Figure 5As shown, in one embodiment, when the infrared thermal imaging lens of the imaging device 10 is used to take pictures to obtain an infrared thermal image of the receiving area at each preset monitoring time node, a positioning auxiliary frame is displayed on the shooting interface 17. The positioning auxiliary frame includes an inner frame 15 and an outer frame 16. The outline of the inner frame 15 is defined by a first coordinate set, and the outline of the outer frame 16 is defined by a second coordinate set.

[0095] Since the outline of the outer frame is defined by the second coordinate set, that is, the outline of the outer frame 16 is consistent with the outline of the free flap 26 transferred to the recipient area, during imaging, it is only necessary to ensure that the outline of the outer frame 16 is consistent with the outline of the free flap 26 transferred to the recipient area. This allows for the rapid determination of the point corresponding to the target blood vessel 23 based on the inner frame 15, thereby quickly determining the first temperature value of the point corresponding to the target blood vessel 23. Furthermore, the positioning auxiliary frame imaging can improve the consistency of the infrared thermogram of the recipient area obtained in each imaging session.

[0096] As a further improvement, when the camera enters the shooting interface 17 for the (n+1)th time at the preset monitoring time node, the current posture of the imaging device is identified based on the posture sensor. If the current posture of the imaging device is identified to be different from the posture during the nth shooting, a posture guidance control is displayed on the shooting interface. The posture guidance control is used to display in real time the difference between the current posture of the imaging device and the posture during the nth shooting, as well as the adjustment direction and adjustment amount of the difference.

[0097] Specifically, the differences include differences in the horizontal direction and differences in the angle of rotation around the vertical direction; such as Figure 5As shown, the attitude guidance control includes a horizontal guidance control and a rotation guidance control. The horizontal guidance control includes a first object 11 that changes position in response to the horizontal attitude of the imaging device and a fixed positioning area 12. The first object 11 can be a circular icon, and the positioning area 12 can be a circular icon. By recording the position of the first object 11 relative to the positioning area 12 at the nth shooting time, the horizontal attitude data at the nth shooting time can be represented. For example, if the first object 11 coincides with the positioning area 12 at the nth shooting time, then at the (n+1)th time entering the shooting interface, the operator also needs to be prompted to adjust the horizontal attitude of the imaging device 10 so that the first object 11 coincides with the positioning area 12. Obviously, the distance and angle between the first object 11 and the positioning area 12 displayed on the shooting interface 17 reflect the difference in the horizontal direction. By observing the difference between the first object 11 and the positioning area 12 on the shooting interface 17, the operator can determine the direction and amount of adjustment. In this embodiment, the guidance for adjusting the horizontal direction is simple and easy to understand. Similarly, the rotation guidance control includes a fixed positioning symbol 13 and a ring 14 that rotates in response to the rotation angle of the imaging device. The ring 14 is marked with corresponding degrees. By recording the degree that the positioning symbol 13 points to on the ring 14 during the nth shot, the attitude data of the rotation angle during the nth shot can be represented. For example, if the positioning symbol 13 points to a position with a degree of 0° on the ring 14 during the n+1th shot, the operation group should be guided to adjust the rotation of the imaging device 10 so that the positioning symbol 13 again points to a position with a degree of 0° on the ring 14. Clearly, the actual degree that the positioning symbol 13 points to on the ring 14 displayed on the shooting interface 17 reflects the difference in rotation direction. By observing the difference between the actual degree that the positioning symbol 13 points to on the ring 14 on the shooting interface 17 and the degree it points to during the nth shot, the operator can determine the adjustment direction and amount of rotation. In this embodiment, the guidance for adjusting the rotation direction is simple and easy to understand.

[0098] In one example, the horizontal guidance control determines the degree of horizontal orientation based on acceleration data detected by an accelerometer along the X, Y, and Z axes. That is, the acceleration data measured by the accelerometer on the X, Y, and Z axes differs depending on the position of the first object relative to the positioning area. For example, when the phone is horizontal, gravitational acceleration acts entirely on the Z-axis of the accelerometer, while the acceleration on the X and Y axes is zero. If the phone is tilted, gravitational acceleration is distributed across the X, Y, and Z axes, allowing the tilt angle to be calculated by measuring the acceleration on each axis. In another example, the rotation guidance control is based on the angle between the imaging device and the magnetic north pole detected by a magnetometer, i.e., the orientation of the imaging device, which is indicated by the degree mark on the ring. For example, when the imaging device is oriented towards the magnetic north pole, the degree is 0°.

[0099] This embodiment improves shooting efficiency, especially when a new operator is assigned, as it can quickly guide the operator to adjust the orientation of the imaging device 10 to a suitable position. Simultaneously, by guiding the shooting orientation, it enhances the consistency of the infrared thermal image of the target area obtained in each shot.

[0100] In one embodiment, the method further includes:

[0101] If, among the (m+1) monitoring results from the nmth monitoring result to the nth monitoring result, the average first temperature value corresponding to each monitoring result shows a decreasing or increasing trend, and T1>T2 and T3-(T1+T2) / 2<θ, then the monitoring time node t_(n+1) of the (n+1)th monitoring result is adjusted as follows:

[0102] t_(n+1)=t_(n)+α*△t; where n and m are positive integers, and m<n; α is a correction coefficient, △t is the preset time interval between two adjacent monitoring time nodes; t_(n) is the nth monitoring time node, 1 / 3≤α≤3 / 4.

[0103] For example, if m=2 and n=5, the monitoring results from the 3rd to the 5th time show that the average temperature of the first temperature is decreasing. Although it does not trigger the first or second level alarm for blood circulation disorder, it reflects the abnormality of blood circulation. Therefore, it is necessary to shorten the actual interval between the 6th and 5th measurements of T1. In this example, we take α=1 / 2 and Δt is one hour. After the fifth temperature measurement is completed, the next measurement should be carried out half an hour later so as to detect the abnormality of blood circulation as early as possible.

[0104] In summary, although the alarm state has not yet been met, the continuous decrease in the average first temperature indicates a high probability of circulatory disturbances. Therefore, it is necessary to increase the frequency of measurements to detect circulatory disturbances earlier. If the average first temperature continues to rise, it indicates an increased risk of inflammation. Therefore, the solution in this embodiment can detect potential signs of inflammation and infection in advance, allowing for further observation and intervention before inflammation occurs.

[0105] like Figure 3 As shown, in one embodiment, the method further includes:

[0106] Step S402: At each preset monitoring time node, a visible light image of the receiving area, including the free skin flap and the surrounding normal skin, is captured using the visible light lens of the imaging device.

[0107] Step S404: Compare the color of the free flap in the visible light image of the receiving area with preset skin color data in the database.

[0108] Step S406: Based on the comparison results, determine the skin color score corresponding to the free flap.

[0109] It should be noted that in this example, color data is randomly collected from multiple locations within the free skin flap and compared with preset skin color data to more fully reflect the overall skin tone of the flap. The preset skin color data includes multiple skin colors and assigns a corresponding score to each.

[0110] In this embodiment, in addition to temperature data, skin color data of the flap can also be monitored. Using an imaging device, multi-dimensional and more comprehensive data on flap blood supply disorders can be collected, improving monitoring efficiency and the accuracy of assessing blood supply disorders.

[0111] In one embodiment, a postoperative blood supply monitoring device for flap transfer is also provided, comprising: a memory, a processor, and a computer program stored in the memory and executable on the processor. When the processor executes the program, it performs the steps of the postoperative blood supply monitoring method for flap transfer described above. The steps of the postoperative blood supply monitoring method for flap transfer may be those described in the various embodiments above.

[0112] In one embodiment, a computer-readable storage medium is also provided, storing computer-executable instructions for causing a computer to perform the steps of the above-described method for monitoring blood supply after flap transfer. The steps of the method for monitoring blood supply after flap transfer can be any of the steps in the methods for monitoring blood supply after flap transfer described in the various embodiments above.

[0113] Those skilled in the art will understand that all or part of the processes in the above embodiments can be implemented by a computer program instructing related hardware. The program can be stored in a non-volatile computer-readable storage medium, and when executed, it can include the processes of the embodiments described above. Any references to memory, storage, databases, or other media used in the embodiments provided in this application can include non-volatile and / or volatile memory. Non-volatile memory can include read-only memory (ROM), programmable ROM (PROM), electrically programmable ROM (EPROM), electrically erasable programmable ROM (EEPROM), or flash memory. Volatile memory can include random access memory (RAM) or external cache memory. By way of illustration and not limitation, RAM is available in various forms, such as static RAM (SRAM), dynamic RAM (DRAM), synchronous DRAM (SDRAM), dual data rate SDRAM (DDRSDRAM), enhanced SDRAM (ESDRAM), synchronous link DRAM (SLDRA), direct RAM via Rambus (RDRA), direct memory bus dynamic RAM (DRDRAM), and dynamic RAM via Rambus (RDRAM), etc.

[0114] The technical features of the above embodiments can be combined in any way. For the sake of brevity, not all possible combinations of the technical features in the above embodiments are described. However, as long as there is no contradiction in the combination of these technical features, they should be considered to be within the scope of this specification.

Claims

1. A blood supply monitoring device after flap transfer surgery, characterized in that, Comprising: A memory, a processor, and a computer program stored on the memory and executable on the processor, wherein when the processor executes the program, it is used to implement the following method: Obtain multiple first temperature values corresponding to multiple first points in a first region of the free flap transferred to the recipient area, and calculate the first temperature average value T1; wherein, the first region is the region corresponding to the target blood vessel running area on the surface of the free flap transferred to the recipient area; the target blood vessel is the blood vessel anastomosed with the blood supply vessel of the recipient area; Obtain multiple second temperature values corresponding to multiple second points in a second region of the free flap transferred to the recipient area, and calculate the second temperature average value T2; wherein, the second region is the other region of the surface of the free flap transferred to the recipient area except the first region; Obtain multiple third temperature values corresponding to multiple third points in the normal skin area near the free flap transferred to the recipient area, and calculate the third temperature average value T3; Based on the relationship among the first temperature average value T1, the second temperature average value T2, and the third temperature average value T3, execute a preset alarm prompt strategy; Wherein, the preset alarm prompt strategy includes: if T1 < T2 < T3 and T3 - (T1 + T2) / 2 < θ, then issue a first-level alarm prompt for blood circulation disorder; if T3 - (T1 + T2) / 2 ≥ θ, then issue a second-level alarm prompt for blood circulation disorder; if T1 > T3, or T2 > T3, then issue an infection and inflammation alarm prompt; θ is a preset temperature difference threshold.

2. The postoperative blood supply monitoring device for flap transfer according to claim 1, characterized in that, When the processor executes the program, it is also used to implement the following method: At each preset monitoring time node, use the infrared thermal imaging lens of the imaging device to capture an infrared thermal image of the recipient area including the free flap and the nearby normal skin; The specific method for obtaining multiple first temperature values corresponding to multiple first points in the first region of the free flap transferred to the recipient area includes: Based on a preset first coordinate set, obtain multiple first temperature values corresponding to multiple first points in the first region from the infrared thermal image of the recipient area; wherein, the coordinates in the first coordinate set are used to define the boundary of the first region; The specific method for obtaining multiple second temperature values corresponding to multiple second points in the second region of the free flap transferred to the recipient area includes: Based on a preset first coordinate set and a second coordinate set, obtain multiple second temperature values corresponding to multiple second points in the second region from the infrared thermal image of the recipient area; wherein, the coordinates in the second coordinate set are used to define the boundary of the free flap transferred to the recipient area; The specific method for obtaining multiple third temperature values corresponding to multiple third points in the normal skin area near the free flap transferred to the recipient area includes: Based on the preset second coordinate set, obtain multiple third temperature values corresponding to multiple third points in the normal skin area near the free flap transferred to the recipient area from the infrared thermal image of the recipient area.

3. The postoperative blood supply monitoring device for flap transfer according to claim 2, characterized in that, The imaging device is simultaneously equipped with a visible light lens and an infrared thermal imaging lens, and the first coordinate set and the second coordinate set are obtained through the following process: While the flap is still in the donor area and in the pedicled flap state, and with the imaging device in the first posture, a visible light image of the first donor area containing the pedicled flap is captured using a visible light lens, and an infrared thermal image of the donor area containing the pedicled flap is captured using an infrared thermal imaging lens. Based on the first mapping relationship between the visible light lens and the infrared thermal imaging lens, a second mapping relationship between the image coordinate systems of the first supply area visible light image and the supply area infrared thermal image is determined; The course of the target blood vessel in the infrared thermal image of the donor area is determined based on the target high-temperature region connected to the pedicle in the infrared thermal image of the donor area. Based on the course region of the target blood vessel in the infrared thermal image of the donor area and the second mapping relationship, the course region of the target blood vessel in the visible light image of the first donor area is determined. With the imaging device in the first position, a visible light image of the second donor area, including the pedicled flap and multiple marker points, is captured using a visible light lens; wherein, the multiple marker points are drawn on the surface of the pedicled flap in the region corresponding to the course of the target blood vessel, with reference to the first visible light image; After the flap becomes a free flap transferred to the recipient area, and with the imaging device in the second posture, a visible light image of the recipient area containing the free flap, multiple markers and nearby normal skin is captured using a visible light lens, and an infrared thermal image of the recipient area containing the free flap, multiple markers and nearby normal skin is captured using an infrared thermal imaging lens. Based on the multiple point pairs formed by the multiple marker points in the second supply area visible light image and the receiving area visible light image respectively, a third mapping relationship between the image coordinate systems of the second supply area visible light image and the receiving area visible light image is obtained; Based on the first mapping relationship, the second mapping relationship and the third mapping relationship, a set of coordinates corresponding to the contour of the target blood vessel in the infrared thermal image of the donor area are transformed to the coordinate system of the infrared thermal image of the recipient area, and the first coordinate set is constructed with the set of coordinates transformed to the coordinate system of the infrared thermal image of the recipient area. The second coordinate set is constructed based on a set of coordinates corresponding to the edge contour of the free flap transferred to the receiving area in the infrared thermal image of the receiving area.

4. The postoperative blood supply monitoring device for flap transfer according to claim 3, characterized in that, Points on the infrared thermal image of the supply area whose temperature difference with the stem does not exceed a preset second temperature difference threshold are defined as high-temperature points. All points in the high-temperature area are high-temperature points. The target high-temperature area connected to the stem means that there must be a high-temperature path among the paths taken from any high-temperature point in the target high-temperature area to the stem. The high-temperature path means that all points along the path are high-temperature points.

5. The postoperative blood supply monitoring device for flap transfer according to claim 3, characterized in that, At each preset monitoring time node, when the infrared thermal imaging lens of the imaging device is used to take pictures to obtain an infrared thermal image of the receiving area, a positioning auxiliary frame is displayed on the shooting interface. The positioning auxiliary frame includes an inner frame and an outer frame. The outline of the inner frame is defined by a first coordinate set, and the outline of the outer frame is defined by a second coordinate set.

6. The postoperative blood supply monitoring device for flap transfer according to claim 5, characterized in that, When the camera enters the shooting interface for the (n+1)th time at the preset monitoring time node, the current posture of the imaging device is identified based on the posture sensor. If the current posture of the imaging device is different from the posture during the nth shooting, a posture guidance control is displayed on the shooting interface. The posture guidance control is used to display the difference between the current posture of the imaging device and the posture during the nth shooting in real time, as well as the adjustment direction and adjustment amount of the difference.

7. The postoperative blood supply monitoring device for flap transfer according to claim 5, characterized in that, When the processor executes the program, it is also used to implement the following methods: If, among the (m+1) monitoring results from the nmth monitoring result to the nth monitoring result, the average first temperature value corresponding to each monitoring result shows a decreasing or increasing trend, and T1>T2 and T3-(T1+T2) / 2<θ, then the monitoring time node t_(n+1) of the (n+1)th monitoring result is adjusted as follows: t_(n+1)=t_(n)+α*△t; where n and m are positive integers, and m<n; α is a correction coefficient, △t is the preset time interval between two adjacent monitoring time nodes; t_(n) is the nth monitoring time node, 1 / 3≤α≤3 / 4.

8. The postoperative blood supply monitoring device for flap transfer according to claim 3, characterized in that, When the processor executes the program, it is also used to implement the following methods: At each preset monitoring time point, a visible light image of the receiving area, including the free skin flap and the surrounding normal skin, is captured using the visible light lens of the imaging device; The color of the free flap in the visible light image of the receiving area is compared with preset skin color data in the database; Based on the comparison results, the skin color score corresponding to the free flap was determined.

Images