Clinical utility of smartphone-based digital infrared thermal imaging in predicting vascular compromise in free flaps

Background: Flap monitoring plays an important role in avoiding morbidity in free flap. Clinical monitoring is considered the gold standard, but it is subjective. Digital thermal imaging captures and displays the infrared radiation emitted from an object. This is useful in assessing temperature diff...

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Main Authors: Padmalakshmi Bharathi Mohan, S. Dineshkumar, Devi Prasad Mohapatra, Prasanth Penumadu, M.T. Friji, Ravi Kumar Chittoria
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-01-01
Series:Journal of Current Research in Scientific Medicine
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Online Access:https://journals.lww.com/10.4103/jcrsm.jcrsm_85_23
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author Padmalakshmi Bharathi Mohan
S. Dineshkumar
Devi Prasad Mohapatra
Prasanth Penumadu
M.T. Friji
Ravi Kumar Chittoria
author_facet Padmalakshmi Bharathi Mohan
S. Dineshkumar
Devi Prasad Mohapatra
Prasanth Penumadu
M.T. Friji
Ravi Kumar Chittoria
author_sort Padmalakshmi Bharathi Mohan
collection DOAJ
description Background: Flap monitoring plays an important role in avoiding morbidity in free flap. Clinical monitoring is considered the gold standard, but it is subjective. Digital thermal imaging captures and displays the infrared radiation emitted from an object. This is useful in assessing temperature difference between two surfaces, as well as variation of temperature. Smartphone thermal imaging can be used to assess the tissue perfusion, which requires little training. Materials and Methods: The aim was to assess the validity of Digital Thermal Imaging in early diagnosis of flap failure, compared to conventional clinical methods. Eleven patients of microvascular-free flap reconstruction for defects following malignancy and trauma were included in the study for January 25, 2019–March 25, 2021. Flaps were monitored using three different methods – clinical monitoring, biochemical monitoring, and digital thermal imaging done at the following interval: (1) intraoperative (end of surgery), (2) hourly – for the first 48 h, (3) every 4th hourly on postoperative days 3–5, and (4) every 6th hourly on postoperative days 5–10, and the results were tabulated. Results: Flap temperature was observed to be higher compared to the surrounding skin when there was an event of venous thrombosis. The surrounding skin temperature was to be measured on the side opposite to the side where the flap was raised to do vascular anastomosis. The increase in the temperature difference almost coincided with the clinical and biochemical indicator of failing flaps. Conclusion: Monitoring of the flap temperature and comparing it with the surrounding skin temperature can be incorporated along with the gold standard. It is a simple, objective, and noncontact method compared to clinical monitoring and biochemical methods. A large sample size, multicentric, randomized controlled study is required to validate the same.
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spelling doaj-art-b5934db1ef854471bb1edceef6913e562025-01-23T05:26:37ZengWolters Kluwer Medknow PublicationsJournal of Current Research in Scientific Medicine2542-62732455-30692024-01-0110110210710.4103/jcrsm.jcrsm_85_23Clinical utility of smartphone-based digital infrared thermal imaging in predicting vascular compromise in free flapsPadmalakshmi Bharathi MohanS. DineshkumarDevi Prasad MohapatraPrasanth PenumaduM.T. FrijiRavi Kumar ChittoriaBackground: Flap monitoring plays an important role in avoiding morbidity in free flap. Clinical monitoring is considered the gold standard, but it is subjective. Digital thermal imaging captures and displays the infrared radiation emitted from an object. This is useful in assessing temperature difference between two surfaces, as well as variation of temperature. Smartphone thermal imaging can be used to assess the tissue perfusion, which requires little training. Materials and Methods: The aim was to assess the validity of Digital Thermal Imaging in early diagnosis of flap failure, compared to conventional clinical methods. Eleven patients of microvascular-free flap reconstruction for defects following malignancy and trauma were included in the study for January 25, 2019–March 25, 2021. Flaps were monitored using three different methods – clinical monitoring, biochemical monitoring, and digital thermal imaging done at the following interval: (1) intraoperative (end of surgery), (2) hourly – for the first 48 h, (3) every 4th hourly on postoperative days 3–5, and (4) every 6th hourly on postoperative days 5–10, and the results were tabulated. Results: Flap temperature was observed to be higher compared to the surrounding skin when there was an event of venous thrombosis. The surrounding skin temperature was to be measured on the side opposite to the side where the flap was raised to do vascular anastomosis. The increase in the temperature difference almost coincided with the clinical and biochemical indicator of failing flaps. Conclusion: Monitoring of the flap temperature and comparing it with the surrounding skin temperature can be incorporated along with the gold standard. It is a simple, objective, and noncontact method compared to clinical monitoring and biochemical methods. A large sample size, multicentric, randomized controlled study is required to validate the same.https://journals.lww.com/10.4103/jcrsm.jcrsm_85_23digital thermal imagingflap monitoringfree tissue transfer
spellingShingle Padmalakshmi Bharathi Mohan
S. Dineshkumar
Devi Prasad Mohapatra
Prasanth Penumadu
M.T. Friji
Ravi Kumar Chittoria
Clinical utility of smartphone-based digital infrared thermal imaging in predicting vascular compromise in free flaps
Journal of Current Research in Scientific Medicine
digital thermal imaging
flap monitoring
free tissue transfer
title Clinical utility of smartphone-based digital infrared thermal imaging in predicting vascular compromise in free flaps
title_full Clinical utility of smartphone-based digital infrared thermal imaging in predicting vascular compromise in free flaps
title_fullStr Clinical utility of smartphone-based digital infrared thermal imaging in predicting vascular compromise in free flaps
title_full_unstemmed Clinical utility of smartphone-based digital infrared thermal imaging in predicting vascular compromise in free flaps
title_short Clinical utility of smartphone-based digital infrared thermal imaging in predicting vascular compromise in free flaps
title_sort clinical utility of smartphone based digital infrared thermal imaging in predicting vascular compromise in free flaps
topic digital thermal imaging
flap monitoring
free tissue transfer
url https://journals.lww.com/10.4103/jcrsm.jcrsm_85_23
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