An overview of current assessment techniques for evaluating cutaneous perfusion in reconstructive surgery

This article provides a comprehensive analysis of modern techniques used in the assessment of cutaneous flaps in reconstructive surgery. It emphasizes the importance of preoperative planning and intra- and perioperative assessment of flap perfusion to ensure successful outcomes. Despite technological advancements, direct clinical assessment remains the gold standard. We categorized assessment techniques into non-invasive and invasive modalities, discussing their strengths and weaknesses. Non-invasive methods, such as acoustic Doppler sonography, near-infrared spectroscopy, hyperspectral imaging thermal imaging, and remote-photoplethysmography, offer accessibility and safety but may sacrifice specificity. Invasive techniques, including contrast-enhanced ultrasound, computed tomography angiography, near-infrared fluorescence angiography with indocyanine green, and implantable Doppler probe, provide high accuracy but introduce additional risks. We emphasize the need for a tailored decision-making process based on specific clinical scenarios, patient characteristics, procedural requirements, and surgeon expertise. It also discusses potential future advancements in flap assessment, including the integration of artificial intelligence and emerging technologies. Explore the latest advancements in assessing cutaneous flaps in reconstructive surgery. This analysis highlights the pivotal role of preoperative planning and perioperative assessment for optimal flap perfusion. Discover non-invasive techniques like acoustic Doppler sonography and near-infrared spectroscopy, alongside invasive methods such as contrast-enhanced ultrasound and near-infrared fluorescence angiography. Delve into the nuances of each approach and gain insights into tailored decision-making processes. image