Use of Recovery-enhanced Thermography to Localize Cutaneous Perforators

Itoh, Yoshiyasu; Arai, Katsuyuki

doi:10.1097/00000637-199505000-00009

Cited by 54 publications

(54 citation statements)

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“…The need for systems that provide dynamic, real-time, intraoperative information about vessel location, perfusion patterns and flap physiology [29], has been addressed by the recent introduction of DIRT. DIRT implies using an infrared camera, which generates a color-coded map based on heat emitted by tissues.…”

Section: Discussionmentioning

confidence: 99%

Using dynamic infrared thermography to optimize color Doppler ultrasound mapping of cutaneous perforators

et al. 2015

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Aims: The high technical demands associated with perforator flaps demand a precise preoperative identification and evaluation of perforator vessels. Color Doppler Ultrasonography (CDU) and Dynamic Infrared Thermography (DIRT) are currently used for preoperative perforator mapping. Each individual technique has advantages and disadvantages. The purpose of this paper is to analyze the value of combining the two methods in order to optimize the process of preoperative perforator mapping. Material and methods: CDU and DIRT were used for preoperative perforator mapping in 10 pigs. The results were compared to intraoperative findings. Total number of perforators, localization, and identification of the dominant perforator was analyzed for each method. The examination time was recorded for each procedure. Results: Both methods had a high sensitivity in determining the number and localization of perforators when compared to those identified during surgery. DIRT produced a higher number of false positive results. CDU accurately identified the emergence of the perforators in the fascia in all cases. Both methods correctly identified the dominant perforator. The sensitivity, positive predictive value, and accuracy of CDU were 93.56%, 97%, and 91.30% respectively and for DIRT 95.05%, 80.67%, and 77.41% respectively. The average examination was 39.76 minutes for CDU and 10.24 minutes for DIRT. The average time taken into account for the analysis of a single perforator in order to confirm DIRT findings was 1.83 minutes. Conclusions: Preoperative perforator mapping has become a compulsory step in nearly all reconstructive procedures. In our study, both CDU and DIRT correctly identified the dominant perforator in all cases. By combining the two examinations overall mapping time can be reduced significantly. A reduced examination time translates into increased patient compliance and a lower procedure cost. The combined mapping technique facilitates the selection of the ideal perforator in all cases. Correctly identifying the dominant perforator preoperatively reduces operative time, lowers complication rates and ensures an overall better result.

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Section: Discussionmentioning

confidence: 99%

Using dynamic infrared thermography to optimize color Doppler ultrasound mapping of cutaneous perforators

et al. 2015

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“…After a recovery period of 3 min, the first appearing hot spots correlate with reliable perforator location. 17,47 Although a simple, low cost and patient safe method it can obviously provide only 2D perforator mapping, while there is no evidence supporting its accuracy Laser-assisted indocyanine green fluorescence angiography (LA-ICGFA) 48 involves peripheral injection of indocyanine green and capture of the cutaneous vascularity with the use of infrared energy. Images are recorded and software analysis data on flap perfusion and patency of anastomosis are collected.…”

Section: Other Methods:-mentioning

confidence: 99%

Integrating Imaging Techniques in Deep Inferior Epigastric Perforator Breast Reconstruction.

Bahhati.¹,

Gravvanis²,

Karakitsos³

et al. 2017

IJAR

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“…Technical advances spurred by military and civil research led to the development of highly sensitive infrared cameras in the 1980s that have been further refined and are currently applied in satellite technology for astronomy, meteorology, and military purposes, e.g., night vision, where humans and warm-blooded animals stand out against a cooler environment, independent on visible illumination. These recent innovations have increased the sensitivity, specificity, and precision of the infrared readings and open new perspectives on possible medical applications [32], including visualization of perforator vessels in fasciocutaneous flaps [33][34][35]. This can be compared with its use in inspection of thermal insulation of buildings, where, for example, open windows or poorly insulated zones represent "leaks" with energy loss.…”

Section: Introductionmentioning

confidence: 99%