Smartphone-based thermography in flap surgery: A systematic review and meta-analysis of perforator identification.

Heliyon

Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, B-2650, Antwerp, Belgium.

Published: March 2024

Background: Thermography can be used in pre-operative planning of free perforator flap surgeries. Thermography assesses skin temperature by measuring the quantity of infrared radiation observed. In this meta-analysis, authors assess the sensitivity of smartphone-based thermal imaging (SBTI) in the detection of perforators and analyze the difference between static and dynamic imaging.

Materials And Methods: Authors followed the PRISMA guidelines for systematic reviews and meta-analyses. The meta package in R was used to conduct the meta-analysis. The "metaprop" function was used to calculate the overall sensitivity estimate and 95% confidence interval. The "metaprop.one" function was used to calculate subgroup estimates for static and dynamic study types. The "metareg" function was used to conduct meta-regression analyses to explore sources of heterogeneity.

Results: This study includes seven articles with 1429 perforators being evaluated. The overall proportion of the sensitivities was estimated to be 0.8754 (95% CI: 0.7542; 0.9414) using a random effects model. The heterogeneity of the studies was high, as indicated by the tau^2 value of 1.2500 (95% CI: 0.4497; 8.4060) and the I^2 value of 92.6% (95% CI: 88.1%; 95.4%). The pooled sensitivity for static imaging was 0.8636 (95%CI: 0.6238-0.9603) with a tau^2 of 2.0661 and a tau of 1.4374, while the pooled sensitivity for dynamic imaging was slightly higher (p = 0.7016) at 0.8993 (95%CI: 0.7412-0.9653) with a smaller tau^2 of 0.8403 and a tau of 0.9167.

Conclusion: Further studies need to confirm that SBTI is a reliable and convenient technique for detecting perforators for the pre-operative planning of free perforator flap surgeries.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10955199PMC
http://dx.doi.org/10.1016/j.heliyon.2024.e26806DOI Listing

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