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Title: Infrared thermography-guided designing and harvesting of pre-expanded pedicled flap for head and neck reconstruction.
Austin Authors: Zhang, Yixin;Xiao, Wentian;Ng, Sally ;Zhou, Huihong;Min, Peiru;Xi, Wenjing;Masia, Jaume;Blondeel, Phillip;Feng, Shaoqing
Affiliation: Department of Plastic Surgery, Shanghai 9th Peoples Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, PR China
Plastic and Reconstructive Surgery
Department of Plastic Surgery, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain..
Department of Plastic and Reconstructive Surgery, Gent University Hospital, Gent, Belgium..
Issue Date: Sep-2021 2021-01-14
Publication information: Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS 2021; 74(9): 2068-2075
Abstract: 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. 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. 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. 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.
DOI: 10.1016/j.bjps.2020.12.102
Journal: Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
PubMed URL: 33551358
Type: Journal Article
Subjects: Flap design
Infrared thermography
Pre-expanded pedicled flap
Vascular mapping
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