Die Smartphone-basierte Thermographie zur Lokalisation von Perforatoren bei der mikrovaskulären Brustrekonstruktion

Walle, Leonard; Fansa, Hisham; Frerichs, O.

doi:10.1055/s-0043-114006

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…We believe that the information on the perforators' perfusion territory could be the most important data supplied by the DIRT, but this is possible only by analyzing the rate and pattern of rewarming, which involved cooling the patient's skin to highlight the spot of higher temperature and improve image resolution(de Weerd et al, 2006; de Weerd et al, 2009; Zetterman et al, 1999). Different types of cooling methods are reported in literature and a gentle cooling challenge within the physiologic range is the most frequently adopted(de Weerd et al, 2006; Kolacz et al, 2017; Walle et al, 2018; Whitaker et al, 2012). Due to subsequent warming after cool challenge, a reduction of the so called “fake hotspots”, namely a small area with no perforators but only superficial blood vessels, is demonstrated and this procedure increases the accuracy of thermal imaging(de Weerd et al, 2009; Tenorio et al, 2011; Thiessen et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Deep inferior epigastric perforator flap preoperative planning: A comparative analysis between dynamic infrared thermography, computerized tomography angiography, and hand‐held Doppler

et al. 2022

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Introduction: Hand-held Doppler (HHD) sonography and computerized tomography angiography (CTA) are the common assessment tools for deep inferior epigastric perforator (DIEP) flap preoperative planning. CTA is considered the gold standard method for preoperative perforator mapping but necessitates contrast medium and X-ray exposure. Dynamic infrared thermography (DIRT) does not have these drawbacks and allows the detection of hot and cold spots on a given body area. Our study aimed to compare DIRT, HHD, and CTA in perforator mapping for breast reconstruction using DIEP flap.Patients and Methods: From March to September 2020, 12 consecutive patients scheduled for DIEP flap breast reconstruction were preoperatively investigated with HHD, CTA, and DIRT. The patients' mean age was 53 and the mean BMI was 29.23 kg/m 2 . All the reconstructions were due to breast cancer.The results of preoperative perforator mapping on the lower abdomen were compared among the three techniques. All the evidence was compared to the intraoperative findings, during flap harvesting, to establish if the techniques were able to correctly locate the perforator.Results: We detected 178 perforators intraoperatively, 178 with CTA, 178 with DIRT, and 125 with HHD. The latter revealed a lower number of perforator vessels for each patient (10.42 ± 3.58), compared with CTA (14.83 ± 3.04) and DIRT (14.83 ± 4.76). DIRT resulted superior to HHD (p < .05), while no statistically significant difference (p > .05) was found between DIRT and CTA. We calculated a mean sensitivity of 93.87% for CTA, 69.02% for HHD, and 92.06% for DIRT. Conclusion:DIRT is a useful tool in the preoperative planning of DIEP flaps, as it provides information about the location of perforators and the hemodynamic properties of angiosomes. It is easy to use, and it does not involve ionizing radiation. DIRT could represent an innovative and promising implementation of CTA and HHD techniques for preoperative perforator mapping in DIEP breast reconstruction.

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Section: Discussionmentioning

confidence: 99%

Deep inferior epigastric perforator flap preoperative planning: A comparative analysis between dynamic infrared thermography, computerized tomography angiography, and hand‐held Doppler

et al. 2022

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“…Patienten mit 13 freien DIEP-Lappenplastiken zur Brustrekonstruktion mittels Smartphonebasierter Thermografie [8]. Die "hot spots" der Hautdurchblutung (Perforatoreintritt) wurden präoperativ am Abdomen dargestellt.…”

Section: Leonard Walle Untersuchte 10unclassified

HaMiPla Best Paper Sitzungen – Ihre Favoriten 2018

Schmid¹,

Gose²,

Prommersberger³

et al. 2019

Handchir Mikrochir plast Chir

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“…Four cold challenge methods commonly found in literature such as alcoholic disinfection, 35 wet laparotomy sponge or towel, 36 airflow produced by fan, 33 37 38 cold pack, or plastic bags filled with cold water, 34 39 40 were chosen for this study. The use of a cold metal plate was excluded beforehand, as it creates an uneven cooling pattern and does not adjust to the thigh curvature.…”

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confidence: 99%

Air Flow Cooling Improves Anterolateral Thigh Perforator Mapping Using the FLIR ONE Thermal Camera

Illg

Krauß

Rothenberger

et al. 2021

J Reconstr Microsurg

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Background Due to the variable vascular anatomy preoperative perforator mapping facilitates anterolateral thigh (ALT) free flap harvesting. Dynamic infrared perforator imaging can assist preoperative planning by displaying hot spots that represent angiosomes. This study aims to compare previously described precooling methods to develop a standardized simplified protocol for ALT perforator planning. Methods Fifty thighs were examined with a FLIR ONE thermal camera. Four different cold challenges, including alcoholic disinfection, wet laparotomy sponge cooling, fan cooling, and cold pack application, were compared. Hot spot locations within a 250 mm × 80 mm area were compared double-blinded to perforator locations determined by Doppler ultrasonography considered as gold standard. Results The matching rate of thermographic hot spots and sonographically identified perforators was 34.9 ± 22.2%. An increased matching rate of 62.2 ± 42.2% was noted taking only favored perforators (septocutaneous course, diameter >1 mm, distance <3 cm to the center, and visible concomitant veins) into account. Precooling with a fan followed by alcoholic disinfection provided clearest thermograms and fastest results. Conclusion Thermographic imaging is a reliable method for perforator imaging. Its supplemental use to ultrasound may reduce examination time and yield additional information. Precooling by air flow or alcoholic disinfection can be easily implemented and provide the best thermograms. The matching rate of thermographic hot spots and perforators increases when taking only clinically relevant perforators into account. Thermal perforator mapping therefore reduces distraction by negligible perforators.

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Die Smartphone-basierte Thermographie zur Lokalisation von Perforatoren bei der mikrovaskulären Brustrekonstruktion

Cited by 5 publications

References 18 publications

Deep inferior epigastric perforator flap preoperative planning: A comparative analysis between dynamic infrared thermography, computerized tomography angiography, and hand‐held Doppler

Deep inferior epigastric perforator flap preoperative planning: A comparative analysis between dynamic infrared thermography, computerized tomography angiography, and hand‐held Doppler

HaMiPla Best Paper Sitzungen – Ihre Favoriten 2018

Air Flow Cooling Improves Anterolateral Thigh Perforator Mapping Using the FLIR ONE Thermal Camera

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