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  • Title: Performance of infrared thermography and thermal stress test in perforator mapping and flap monitoring: A meta-analysis of diagnostic accuracy.
    Author: Raheman FJ, Rojoa DM, Patel NG.
    Journal: J Plast Reconstr Aesthet Surg; 2021 Sep; 74(9):2013-2025. PubMed ID: 34011474.
    Abstract:
    BACKGROUND: Accurate mapping of perforators prior to flap reconstruction and early detection of poor flap perfusion reduces the risk of flap failure. Infrared thermography (IRT) has recently regained popularity within reconstructive surgery to aid flap design, reduce operative time and assess flap viability based on surface temperature changes. The aim of this review is to quantify the diagnostic ability of IRT in perforator mapping preoperatively and monitor flap perfusion perioperatively. METHODS: We conducted a systematic review of literature and included all studies that evaluated the use of IRT for perforator mapping and flap perfusion monitoring. We used a mixed-effects logistic regression bivariate model to estimate the summary sensitivity and specificity and constructed hierarchical summary receiver operative characteristic (HSROC) curves. OUTCOME: We identified 18 studies and observed IRT to have sensitivities of 99.6% and 89.6% with specificities of 99.9% and 96.0% for perforator mapping and flap monitoring, respectively. Moreover, IRT recognises patterns of perfusion within interperforator zones through visualisation of angiosomal rewarming and may improve flap outcomes.
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