AI Article Synopsis
- Pre-expanded pedicled flaps are more flexible and efficient than random flaps but depend heavily on precise axial vessel mapping for successful surgical outcomes.
- The study employed Infrared Thermography (IRT) to track vessel distribution in patients undergoing head and neck reconstruction, comparing results with other imaging techniques like color Doppler ultrasound and computed tomographic angiography.
- IRT effectively mapped vessel distribution in all cases and proved to be a more comprehensive and reliable tool than traditional methods, making it easier to design and safely harvest flaps.
Article Abstract
Background: Pre-expanded pedicled flaps possess a more flexible transfer pattern and higher tissue utilization than random flaps, but the perfusion is fully dependent on the chosen axial vessels. A precise mapping of the vessels would assist the surgical design and increase the likelihood of success. The application of Infrared thermography (IRT) has been previously reported for perforator location. The aim of this study is to report the use of IRT in mapping the course and distribution of axial vessels in the pre-expanded flap to guide the designing and harvesting.
Methods: Patients who underwent head and neck reconstruction using pre-expanded flaps were included. After tissue expansion, IRT was used to mark the vessel distribution along the expanded flap. The results were compared with color Doppler ultrasound (CDU) and/or computed tomographic angiography (CTA). The flap was designed and raised based on the pre-operative marking by IRT. The mark was verified intraoperatively.
Results: A total of 26 expanded flaps were performed, including 20 pedicled flaps and 6 free flaps. IRT succeeded to map the vessel distribution in all cases. All marked results were verified by CDU, CTA, and intraoperative dissection (26/26, 100%). IRT showed more comprehensive distribution of vascular branches than CDU or CTA, and could be utilized intraoperatively to identify the arteries.
Conclusion: IRT provides accurate and comprehensive mapping of the axial vessel distribution in the pre-expanded flaps, assisting with flap design and harvest. It is easy to use and non-invasive as an important tool pre- or intraoperatively to ensure the safe elevation.
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| http://dx.doi.org/10.1016/j.bjps.2020.12.102 | DOI Listing |
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