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Advancing DIEP Flap Monitoring with Optical Imaging Techniques: A Narrative Review.

Hailey Hwiram Kim1, In-Seok Song1,2, Richard Jaepyeong Cha1,3

  • 1Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC 20010, USA.

Sensors (Basel, Switzerland)
|July 27, 2024
PubMed
Summary

Optical imaging techniques like NIRS and ICG angiography offer real-time monitoring for Deep Inferior Epigastric Perforator (DIEP) flap viability. These methods enhance surgical outcomes by detecting perfusion issues early, reducing flap loss risks.

Keywords:
DIEP flap reconstructionsurgical outcomestissue perfusion

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Area of Science:

  • Plastic Surgery
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Deep Inferior Epigastric Perforator (DIEP) flap reconstruction is crucial for breast reconstruction.
  • Monitoring flap viability is essential to prevent complications like partial or total flap loss.
  • Current monitoring methods may have limitations in providing real-time, objective perfusion data.

Purpose of the Study:

  • To review recent advancements in optical imaging techniques for DIEP flap viability monitoring.
  • To highlight the principles, applications, and clinical utility of various optical imaging modalities.
  • To discuss the potential of these techniques in improving surgical outcomes through timely intervention.

Main Methods:

  • Comprehensive literature review of PubMed, MEDLINE, and other databases.
  • Inclusion of studies on near-infrared spectroscopy (NIRS), ICG fluorescence angiography, LSCI, HSI, DIRT, and SWIR.
  • Synthesis of data on technique effectiveness, advantages, limitations, and impact on surgical decision-making.

Main Results:

  • Optical imaging offers non- or minimally-invasive, real-time assessment of DIEP flap perfusion and oxygenation.
  • Techniques provide objective, quantitative data for accurate flap viability monitoring.
  • Effectiveness demonstrated in detecting compromised perfusion, enabling timely intervention and reducing flap loss.
  • Optical imaging shows promise in improving surgical outcomes by guiding intraoperative decisions.

Conclusions:

  • Optical imaging techniques are valuable tools for DIEP flap viability monitoring.
  • NIRS, ICG, LSCI, HSI, DIRT, and SWIR provide real-time perfusion and oxygenation assessment.
  • These modalities can enhance surgical outcomes by reducing flap complications and informing patient care.