Dynamic infrared thermography and smartphone thermal imaging as an adjunct for preoperative, intraoperative, and postoperative perforator free flap monitoring

摘要

Aim: The versatile application of perforator free flaps for coverage of any extremity has been well proven. Often, a "freestyle"- like approach is used to design these flaps, as conventional imaging techniques for perforator identification may be too expensive or unavailable. As will be demonstrated, the recent application of a thermal imaging camera using a smartphone is a cheaper and therefore more universal means to better identify the requisite perforators upon which a free flap can be designed and then monitored. Methods: Smartphone thermography can be used on any patient preoperatively to identify preferable perforators or vascular network "hot spots" within the desired donor site territory. Intraoperative management of the choice of perforators and subsequent flap dissection can be similarly facilitated. Intermittent postoperative monitoring based on changes of the thermal image color palette will provide a comparison that can be used to determine if perfusion across the microanastomosis is sustained. Results: An overview of how to use a smartphone in concert with a thermal imaging camera is outlined. Dynamic infrared thermography represents a thermal stress necessary with a smartphone to better identify donor site "hot spots".Conclusion: Smartphone thermography is an inexpensive and expeditious means for identification of "hot spots" that correlate with perforators that would suffice to insure perfusion to a free perforator flap. However, since perforator caliber and course cannot be determined, this should be considered to be only a complementary adjunct for conventional methods. Nevertheless, its simplicity will overall improve the safer design, harvest, and subsequent monitoring of free flaps.