Assessment of fasciocutaneous perforator flaps using thermal imaging
Research type
Research Study
Full title
Prospective observational study to evaluate thermal imaging as a functional vascular imaging tool for fasciocutaneous perforator flaps
IRAS ID
279874
Contact name
Afshin Mosahebi
Contact email
Sponsor organisation
Royal Free London NHS Foundation Trust Hospital
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Perforator flap surgery is a technique used in reconstructive surgery where skin and subcutaneous fat are transferred from one part of the body to reconstruct a body defect that may result following trauma or after excision of a diseased part such as tumour. Perforators are the vessels that supply blood to the flap and are derived from a deep vascular system.
Identification of the most appropriate flap perforator(s) is a critical component in reconstructive surgeries. A wide variety of preoperative imaging modalities have been utilized in order to identify perforators such as Duplex ultrasound, hand-held Doppler ultrasound, computed tomography angiogram (CTA) and magnetic resonance angiogram (MRA). However, each of these modalities has its own disadvantages, and all of them assess perforators during the preoperative planning phase, but cannot be used during the operation or in flap monitoring after surgery.
Thermal imaging has been used in mapping of skin perforators depending on the relationship between temperature of the skin and emitted infrared radiation from the skin surface. In this technology, a patient’s skin temperature can be used to produce images based on the skin infrared radiation. Furthermore, it has been confirmed that skin perfusion, which is the delivery of blood through the perforators, and skin temperature are well correlated to each other. Therefore, indirect information about skin perfusion can be obtained by measuring the temperature of the skin using thermal imaging. The FLIR ONE Pro is a smartphone compatible thermal imaging camera which is able to measure the infrared emission from the skin and take photographs to be analyzed using specialized software. This technique has been proposed by many authors being a low-cost, non-contact, non-invasive technique, with no adverse reactions and helpful in preoperative mapping, intraoperative assessment and postoperative flap monitoring.
We wish to evaluate the use of thermal imaging as a new technique that can be used for identification of flap perforators. We wish to evaluate the accuracy of thermal imaging as a functional vascular imaging modality by comparing it against the current standard of care which is CT Angiogram. We plan to study up to 50 patients in total.REC name
London - Surrey Borders Research Ethics Committee
REC reference
20/PR/0833
Date of REC Opinion
16 Dec 2020
REC opinion
Unfavourable Opinion