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Objective:To compare the reliability between infrared thermal imaging technology(IRT) and colour Doppler ultrasound (CDU) in the detection of perforators for anterolateral femoral perforator flap(ALTPF).Methods:From September, 2017 to September, 2019, a total of 25 patients(16 males and 9 females, aged 12-53 years old with an average age of 38.7 years old) underwent ALTPF surgery for the purpose of resurfacing and reconstruction. All patients had pedicled or free ALTPF sized from 5.0 cm×8.0 cm to 7.5 cm×30.0 cm. Among all cases, 21 received free flaps and 4 received pedicled flaps. All patients underwent routine IRT and CDU examinations to locate the perforators preoperatively.Results:Of the 25 patients, CDU detected 53 perforators and IRT detected 51 "hot spots". There were 50 "hot spots" that corresponded to the findings of CDU with a κ index at 0.712( P<0.05), representing a high degree of consistency. The sensitivity and specificity were 94.3% and 85.7%, respectively. Conclusion:IRT has a high consistency in detecting perforators for ALTPF in comparison with CDU. IRT features portable, low cost, non-invasive, and easy to operate. At the same time, IRT has advantages in the patients who have thin subcutaneous tissue. With higher accuracy, IRT is expected to become an important part of preoperative perforator navigation.
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The location of perforator vessel and blood supply of the flap are the most concerned issues in flap surgery. Recently, infrared thermography (IRT) has been gradually applied in flap surgery as a portable, non-invasive, rapid and economical measure. It detects the infrared radiation emitted by the human body and accurately describes the thermal distribution on the surface of tissues. This review summarizes the application of infrared thermography in different aspects including perforator detection and perfusion monitoring. This review also summarizes the potential value of the use of infrared thermography to provide references and assistance for clinicians in improvement of surgical outcomes in the flap surgery.
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Objective To introduce the classification of the perforators of the superficial circumflex iliac artery(SCIA),and the superficial circumflex iliac artery perforator (SCIP) flaps based on different perforators have different characters and harvesting methods.To explore a set of coping strategy for the drawbacks of the SCIP flap.Methods Review 90 cases of SCIP flaps in August,2011 to June,2017.The pre-operative radiology navigation was conducted in all cases.Different surgical approaches were applied in flaps based on different perforators.The pedicle elongation method was adopted when necessary.The thickness of the flap,the length of the pedicle,the survival rate of the flap and the closure of the donor site were analyzed.Regular follow-up was performed after the operation.Results All flaps were followed-up for 6-15 months (average 8 months).Fifty-seven flaps were raised on the basis of the proximal perforators of the superficial branch of the SCIA,whereas 29 cases were based on the distal perforators from the deep branch,and in 4 cases,the pedicle was switched to the superficial inferior epigastric artery.In 8 cases,the arterial pedicle lengthen technique was applied with a maximum length of 10 cm.All donor sites were closed directly.Conclusion These surgical strategies simplified the intraoperative decision-making and conquered the shortcomings of the SCIP flap.It is believed that the SCIP flap can possibly become the new workhorse flap in the field of reconstructive surgery.