Dynamic infrared thermography for the preoperative planning of microsurgical breast reconstruction: A comparison with CTA

Whitaker, Iain S.; Lie, Kwok Hao; Rozen, Warren M.; Chubb, Daniel; Ashton, Mark W.

doi:10.1016/j.bjps.2011.07.016

Cited by 25 publications

(33 citation statements)

References 10 publications

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“…This was confirmed by intraoperative observations in which the found vessels corresponded to those marked in thermography only if their diameter was greater than 1 mm. If the diameter was smaller than 1 mm “hot spots” did not always appear in thermography – the authors, however, do not give statistical elaborations [ 6 , 8 , 10 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

The use of thermography to design tissue flaps - experimental studies on animals.

Czapla

Łokaj

Falkowski

et al. 2014

Videosurgery and Other Miniinvasive Techniques

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IntroductionMethods allowing one to locate the position of a cutaneous perforator do not allow one to determine the boundaries of the vascularized skin. In clinical practice this causes complications in the form of marginal necrosis of the flap.AimTo examine the usefulness of thermography to assess the extent of vascularization of the skin and subcutaneous tissue by a single perforator.Material and methodsThirty-one male rats were used. Using dynamic thermography the perforators on the abdominal skin were located. Afterwards the flap was prepared on a randomly chosen perforator. After 24 h the extent of vascularization of the skin by a single perforator was examined.ResultsIn 22.5% of cases the number of perforators marked in the thermography was equal to the number of perforators marked intraoperatively, in 64.5% it was lower and in 13% higher. The use of thermography has shown that basing the flap vascularization on the perforator with low efficiency resulted in statistically more frequent occurrence of ischemia and partial necrosis of the flap (p = 0.024). Partial necrosis of the flap occurred in 12 of 31 cases, always in the area in which during the preoperative thermography no perforators were found. The areas of necrosis occurred irrespectively of the distance from the supplying vessel.ConclusionsWhen designing the shape of the flap, the distribution of all perforators must be considered. The perforators need to be included in the area of prepared tissues because their location indicates the area with a more efficient network of vessels.

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Section: Discussionmentioning

confidence: 99%

The use of thermography to design tissue flaps - experimental studies on animals.

Czapla

Łokaj

Falkowski

et al. 2014

Videosurgery and Other Miniinvasive Techniques

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show abstract

“…When selecting a suitable perforator, thermography provides additional information for imaging perforatorbased flaps. sind vielversprechend [10,11]. Der Chirurg erhält objektive Evidenz über die Perfusionsareale an der Haut.…”

Section: Originalarbeitunclassified

“…Der Chirurg erhält objektive Evidenz über die Perfusionsareale an der Haut. Ein Rückschluss auf zugehörige Perforatoren scheint möglich [10]. Durch die Darstellung von "hot spots" an der Haut stellt die Thermographie ein ergänzendes Tool in der Bildgebung dar und hilft bei der Entscheidungsfindung für den geeigneten dominanten Perforator [12].…”

Section: Originalarbeitunclassified

“…Whitaker und Kollegen beschreiben in einem Fallbeispiel die synergistischen Effekte zwischen CTA und Thermographie [10]. Bei einer 41-jährigen Patientin war eine beidseitige DIEP-Brustrekonstruktion geplant.…”

Section: Diskussionunclassified

“…In der dazugehörigen Thermographie war rechts paraumbilical eine deutlicher "hot spot" sichtbar, wohingegen links keine "hot spots" darstellbar waren. Es wurde dementsprechend für die eine Brust eine DIEP-Lappenplastik von rechts durchgeführt und für die andere Brust eine Implantat-basierte Rekonstruktion [10].…”

Section: Diskussionunclassified

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

Walle

Fansa

Frerichs

2018

Handchir Mikrochir plast Chir

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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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Dynamic infrared thermography for the preoperative planning of microsurgical breast reconstruction: A comparison with CTA

Cited by 25 publications

References 10 publications

The use of thermography to design tissue flaps - experimental studies on animals.

The use of thermography to design tissue flaps - experimental studies on animals.

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

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

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