Skin flap transplantation is a common method for surgical repair of various types of wounds. The temperature of the skin flap reflects the blood supply and venous reflux of it, which can help detect vascular crises in the early stage. However, how to accurately measure the temperature of skin flap and its specific predictive role in vascular crises remains unclear.

To explore the difference in flap temperature between the "five points" and "single point" flaps and their accuracy and optimal cut-off values in predicting vascular crisis.

Adult inpatients who underwent flap transplantation surgery from January 2021 to July 2023 were included. Beginning on day 1 after surgery, non-contact infrared thermometers were used every 2 hours to measure the skin flap temperature using the "five points method" at the center point, edge at 12 o'clock, 3 o'clock, 6 o'clock, and 9 o'clock of the skin flap, the temperature readings were obtained by pausing for 3 seconds at a distance of 3cm from each site, and the average temperature of the "five points" was taken to compare with the center single point temperature of the skin flap. The "cotton buds-press method" was simultaneously used to monitor the capillary response of the skin flap and observe the color of skin flap for 5 consecutive days.

A total of 66 patients with various types of skin flap surgeries were included, with males and females accounting for 59.09% (39/66), and 40.91% (27/66), respectively. The average age was (45.03±17.00) years old. The changes of the "five points" flap temperature and the "single point" flap temperature from 1-5 days after surgery were the lowest on the first day after surgery, and gradually increased thereafter. The incidence of vascular crisis was 15.15% (n=10) and, which occurred mainly within 3 days after surgery, and the "five points" flap temperature was lower than the "single point" flap temperature (P<0.001). The receiver operating characteristic (ROC) curves of "five points" flap temperature and "single point" flap temperature predicting vascular crisis were plotted and the results showed that the area under curve (AUC) of "five points" flap temperature predicting vascular crisis was 0.87 (95%CI=0.74-0.99), the sensitivity and specificity were 90% and 75%, the Youden index was 0.65, and the optimal cut-off value was 35.96℃. The AUC of "single point" flap temperature predicting vascular crisis was 0.76 (95%CI=0.61-0.91), the sensitivity and specificity were 70% and 71%, the Youden index was 0.41, and the optimal cut-off value was 36.18 ℃.

The "five points" flap temperature was lower than that of the "single point" flap temperature, the accuracy and authenticity of the former is slightly better than the latter in predicting vascular crisis.

皮瓣移植是手术修复各类伤口的常用方式，皮瓣温度反映了皮瓣的血液供应和静脉回流状况，有助于早期发现血管危象，但如何准确测量皮瓣温度及其对血管危象的具体预测作用尚不明确。

探讨"五点"和"单点"皮瓣温度差异及其预测血管危象的准确性与最佳临界值。

纳入2021年1月—2023年7月接受皮瓣手术的成年住院患者，从术后第1天开始，每2 h一次采用非接触式红外线测温仪按照皮瓣中心点、边缘12点、3点、6点、9点的"五点法"测量皮瓣温度，距离每个部位3 cm停顿3 s获取温度读数，取"五点"温度的平均值，与皮瓣中心点的"单点"温度比较，同时采用"棉签压迫法"监测皮瓣的毛细血管反应，观察皮瓣颜色，连续监测5 d。

共纳入66例各类皮瓣手术患者，男、女各占59.09%（39/66）和40.91%（27/66），平均年龄（45.03±17.00）岁，术后1~5 d的"五点"皮瓣温度和"单点"皮瓣温度的变化规律均为术后第1天温度最低，此后逐渐升高。血管危象发生率为15.15%，主要发生于术后3 d内，"五点"皮瓣温度低于"单点"皮瓣温度（P<0.001）。绘制"五点"皮瓣温度和"单点"皮瓣温度预测血管危象的受试者工作特征曲线，结果显示"五点"皮瓣温度预测血管危象的曲线下面积为0.87（95%CI=0.74~0.99），灵敏度和特异度为90%和75%，约登指数为0.65，最佳截断值为35.96 ℃；"单点"皮瓣温度预测血管危象的曲线下面积为0.76（95%CI=0.61~0.91），灵敏度和特异度为70%和71%，约登指数为0.41，最佳截断值为36.18 ℃。

"五点"皮瓣温度低于"单点"皮瓣温度，前者预测血管危象的准确性和真实性稍优于后者，临床采用"五点法"测量的皮瓣温度更准确。