Perfusion in Pedicled Skin Flaps: Initial Insights from Smartphone-Based Thermal Imaging Protocol

Area of Science:

• Surgical Innovation
• Medical Imaging
• Head and Neck Surgery

Background:

• Maintaining pedicled skin flap perfusion is crucial for successful head and neck reconstructive surgery.
• Thermal imaging offers a noninvasive method to assess tissue perfusion and predict flap viability.

Purpose of the Study:

• This pilot study investigated the utility of smartphone-based thermal imaging (SBTI) for predicting flap vitality.
• The research aimed to evaluate SBTI's role in intraoperative monitoring during head and neck surgery.

Main Methods:

• Thermal imaging was performed using the FLIR One System with a defined protocol for pedicled skin flaps.
• SBTI was integrated into reconstructive procedures for head and neck defects, assessing 11 flaps.
• Images were correlated with clinical assessments, with thermal images graded by surgeons based on temperature differences.

Main Results:

• Intraoperative SBTI assessments consistently indicated good flap perfusion across the 11 cases.
• One postoperative dehiscence correlated retrospectively with SBTI grading, though not initial clinical assessment.
• Statistical analysis showed consistent outcomes between clinical and SBTI assessments, with SBTI accurately predicting flap viability, despite limitations with small flaps.

Conclusions:

• Smartphone-based thermal imaging (SBTI) is an effective, inexpensive, and noninvasive method for assessing tissue perfusion.
• SBTI shows significant promise for predicting flap viability and for intraoperative monitoring in head and neck surgery.