Role of Infrared Thermography in Planning and Monitoring of Head and Neck Microvascular Flap Reconstruction
Research article published in Plastic and reconstructive surgery. Global open (2023)
Resumen
BACKGROUND: Reconstruction using microvascular free flaps has become the standard of care in head and neck cancer surgery, and their success lies in appropriate planning, adequate revascularization, and early detection of flap compromise so that prompt salvage is possible. This study evaluates the role of infrared thermography in the planning, execution, and postoperative monitoring of microvascular flaps in head and neck reconstructions. METHODS: This is a single institutional, prospective observational study conducted at a tertiary care hospital in South India for 13 months. Twenty patients were included, and their thermographic images were captured in the preoperative, intraoperative, and postoperative settings using the infrared camera FLIR T400. These images were analyzed along with the Doppler, and clinical monitoring findings in all the settings and the temperature difference were calculated postoperatively. RESULTS: Hotspot perforator marking was made using infrared camera, and perforator marking was made using hand-held Doppler preoperatively, which correlated in 93% of cases. Intraoperatively, flap rewarming was successfully demonstrated in 19 of 20 cases. Postoperatively, flap compromise was observed on infrared thermography during the first 24 hours but not on clinical monitoring in three cases. The temperature difference values recorded were 5.4°C, 2.4°C, and 4.9°C. The mean of temperature difference of the healthy flaps was 1.0°C (range 0.1°C-1.8°C). CONCLUSION: Infrared thermography provides simple and reliable imaging, which can be used in perforator marking and flap designing preoperatively and checking the flap perfusion and vascular anastomosis patency intra- and postoperatively.
Resumen tomado de PubMed (NCBI) para el registro citado, en el idioma original. La versión de referencia es la de la publicación original.
El resumen se deja sin traducir para conservar la redacción original de los autores.
Síntesis
In 20 head and neck free flap reconstructions, infrared thermography matched Doppler perforator marking in 93% of cases, showed intraoperative flap rewarming in 19 of 20, and detected three episodes of flap compromise within 24 hours that clinical monitoring missed.
Por qué esto importa para la hirudoterapia
Este estudio prospectivo observacional de una sola institución de 20 pacientes con colgajos microvasculares libres de cabeza y cuello evaluó la termografía infrarroja a lo largo del curso perioperatorio, reportando una correlación del 93% con el Doppler portátil para la marcación de perforantes, una demostración exitosa de recaimiento del colgajo en 19 de 20 casos, y la detección de compromiso del colgajo en termografía dentro de las primeras 24 horas en tres casos donde la monitorización clínica no lo hizo, con colgajos sanos mostrando una diferencia media de temperatura de aproximadamente 1,0°C. Esto tiene relevancia para la hirudoterapia porque la detección temprana y fiable del compromiso del colgajo o del replante — especialmente la congestión venosa — es lo que desencadena la aplicación de sanguijuelas, y un adjunto de imagen de bajo costo que señale la perfusión fallida antes podría mejorar el momento del salvamento basado en sanguijuelas. Como una pequeña serie prospectiva de 20 pacientes en un solo centro, es evidencia metodológica preliminar sobre una herramienta de monitorización y no dice nada sobre la terapia con sanguijuelas en sí.
Citación
Role of Infrared Thermography in Planning and Monitoring of Head and Neck Microvascular Flap Reconstruction.
Chava SK et al. · Plastic and reconstructive surgery. Global open, 2023
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Añadido a la biblioteca ASH: 28 de mayo de 2026 · Última actualización del sitio: 18 de junio de 2026