Dynamic infrared thermography is a promising new optical technique that could help surgeons reduce the rate of flap failure in breast reconstruction surgery following mastectomy. Unlike other contrast-enhanced imaging methods that involve introducing a liquid or gas “tracer” into the patient—e.g.
, computed tomography (CT) angiography, fluorescence angiography, or Xenon-enhanced CT—in dynamic infrared thermography
the blood is ‘tagged’ using thermal energy. The procedure works like this: After the tissue of interest is cooled, it is perfused by normothermic (normal body temperature) blood while being imaged with an infrared thermal camera. The temporospatial signal can then be used to assess, for example, the area perfused by a perforator artery during a free flap transfer procedure. In this paper by Jan Verstockt and colleagues from the University of Antwerp in Belgium, dynamic infrared thermography was used in a pilot study to evaluate perforators in patients undergoing deep inferior epigastric artery perforator flap (DIEP) transfer for breast reconstruction following mastectomy. Flap failure remains a devastating complication in these procedures and is often caused by poor flap perfusion following the anastomosis of inadequate perforator vessels. This paper demonstrates, in principle, that dynamic infrared thermography could be used to identify the strongest perforator vessel by cooling the flap, selectively clamping and unclamping perforators and imaging the resulting change in flap temperature with infrared thermography. The ability to accurately identify the dominant perforator in DIEP flaps could lead to fewer flap failures and better clinical outcomes in these patients.
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