Intraoperative use of dynamic infrared thermography and indocyanine green fluorescence video angiography to predict partial skin flap loss

Miland, Åshild O.; Weerd, Louis de; Mercer, James B.

doi:10.1007/s00238-007-0201-3

Cited by 16 publications

(14 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, an animal study using DIRT and ICG-FA to predict partial flap necrosis in a pedicled flap demonstrated that intraoperative DIRT findings overestimated flap survival by 5%–6%, while intraoperative images of ICG-FA underestimated flap survival by 6%–10%. 29 When this limitation is acknowledged, DIRT may be useful to assess distal flap perfusion. Unlike CTA and ICG-FA, DIRT does not require intravenous injection or exposure to ionizing radiation.…”

Section: Discussionmentioning

confidence: 99%

The Value of Dynamic Infrared Thermography in Pedicled Thoracodorsal Artery Perforator Flap Surgery

Sjöberg

Mercer

Weum

et al. 2020

Plastic and Reconstructive Surgery - Global Open

Self Cite

View full text Add to dashboard Cite

Background: Dynamic infrared thermography (DIRT) is a noninvasive imaging technique that can provide indirect and real-time information on skin perfusion by measuring skin temperature. Although used in flap surgery, there are no reports on its value in procedures using a pedicled thoracodorsal artery perforator (TDAP) flap. The aim of this study was to assess the usefulness of DIRT in preoperative perforator mapping and in monitoring intra- and postoperative flap perfusion of pedicled TDAP flaps. Methods: This prospective study comprised 21 patients (21 flaps) scheduled for reconstructive surgery with a TDAP flap. Perforator mapping was done by DIRT, handheld unidirectional Doppler ultrasound, and computer tomography angiography. Intra- and postoperative flap perfusion was assessed by clinical signs and with the use of DIRT and handheld unidirectional Doppler ultrasound. Results: Perforator mapping with DIRT showed that first-appearing bright hotspots were always associated with arterial Doppler sounds and suitable perforators intraoperatively. Computer tomography angiography presented useful information on the thoracodorsal artery branching pattern but was less beneficial for perforator mapping. Intra- and postoperative flap monitoring with DIRT was more useful than handheld unidirectional Doppler ultrasound and clinical signs to detect early arterial and venous perfusion problems. DIRT demonstrated that TDAP flap perfusion is a dynamic process with an increase in perfusion during the first operative days. Nineteen flaps survived, of which 3 sustained distal necrosis. Two flaps were lost due to inadequate blood perfusion. Conclusion: DIRT provides valuable real-time information for perforator mapping and for monitoring TDAP flap perfusion intra- and postoperatively.

show abstract

Section: Discussionmentioning

confidence: 99%

The Value of Dynamic Infrared Thermography in Pedicled Thoracodorsal Artery Perforator Flap Surgery

Sjöberg

Mercer

Weum

et al. 2020

Plastic and Reconstructive Surgery - Global Open

Self Cite

View full text Add to dashboard Cite

show abstract

“…Patients with heart diseases have achieved many benefits from the advancement of thermographic technique applications. Thermal angiography [51][52][53] is used to check the cooling effects of cardioplegia liquids. Patients undergoing bypass [54,55] surgery also take advantage of intraoperative thermography for the detection of coronary graft flow restrictions [96].…”

Section: Medical Applications Of Thermographymentioning

confidence: 99%

“…Thermography has been a part of diagnosis in various medical fields. Its use in angiography [51][52][53], heart surgery [54,55], and for prevention and early detection of breast cancer [56][57][58][59][60][61][62][63] is well established. IR thermography has been used to observe and measure the temperature gradient of bone [64][65][66][67] and dental implants [68,69] when subjected to drilling.…”

Section: Introductionmentioning

confidence: 99%

Nondestructive Evaluation Of A Polymer Composite Hip Implant Using Lock-In Thermography

Rahim¹

2021

Preprint

View full text Add to dashboard Cite

Lock-in thermography, combined with finite element analysis and experimental testing, was used to investigate the stress/strain pattern in a novel composite hip implant made of carbon fibre and polyamide 12 (CF/PA12). In this study, the geometry of the hip implant was first modelled and analysed in ANSYS workbench 11. Different virtual loads of 800N, 1400N and 2200N were applied on the finite element model of the hip stem at an adduction angle of 15º, thereby replicating the present experimental setup. The values of strains obtained were confirmed by replicating the experiment by using strain gauges. A Pearson's correlation (R²=0.98) was obtained, which indicated good agreement between the FEA model and experimental hip stem. The hip implant was again subjected to similar loading conditions, and stresses were recorded by using a thermal camera at corresponding vertices. The comparison of results showed good agreement between the values of stress calculated from the strain gauge experiment and stress obtained from thermography. This study showed that it was possible to find stresses in a hip implant reliably by thermography.

show abstract

“…While the drawbacks of traditional fluorescein imaging (long half-life, superficial depth of imaging, leakage of the dye into the interstitium, anaphylactic reactions) have often outweighed the potential benefits, laser-induced fluorescence imaging using indocyanine green (ICG) as a flow tracer is increasingly being used to visualise tissue perfusion in real-time during the course of surgery. [8][9][10][11][12] ICG has a very low level of toxicity, is rapidly metabolised, is greater than 95% protein bound and, hence, confined to the vascular compartment. 13 Unlike fluorescein, ICG fluorescence is excited and observed at near infrared (NIR) wavelengths that allow visualisation of deeper vascular networks compared to angiography based on visible or ultraviolet light fluorescence.…”

Section: Introductionmentioning

confidence: 99%

The Utility of near Infrared Imaging in Intra-Operative Prediction of Flap Outcome: A Reverse McFarlane Skin Flap Model Study

Sowa

Friesen

Levasseur

et al. 2012

Journal of Near Infrared Spectroscopy

View full text Add to dashboard Cite

Skin flaps are complex procedures used extensively in reconstructive surgery that require post-operative monitoring to ensure that they do not fail. Near infrared (NIR) spectroscopic imaging is a convenient, non-invasive method for surgeons to examine flaps during surgery and in the early post-operative period. Using a reverse McFarlane skin flap model, we show that model-free chemometric methods as well as simple modified Beer-Lambert analysis of the NIR images provide insights into the blood supply to flaps and demonstrate that the technique can detect and localise perfusion-related complications as well as give real-time feedback to the surgeon as they try to resolve the complication. We also show that using estimates of tissue haemoglobin oxygen saturation, imaging measurements made during surgery and in the early post-operative period are highly predictive of the outcome of the flap tissue with specificities and sensitivities exceeding 85%.

show abstract

Intraoperative use of dynamic infrared thermography and indocyanine green fluorescence video angiography to predict partial skin flap loss

Cited by 16 publications

References 27 publications

The Value of Dynamic Infrared Thermography in Pedicled Thoracodorsal Artery Perforator Flap Surgery

The Value of Dynamic Infrared Thermography in Pedicled Thoracodorsal Artery Perforator Flap Surgery

Nondestructive Evaluation Of A Polymer Composite Hip Implant Using Lock-In Thermography

The Utility of near Infrared Imaging in Intra-Operative Prediction of Flap Outcome: A Reverse McFarlane Skin Flap Model Study

Contact Info

Product

Resources

About