Early Detection of Vascular Obstruction in Microvascular Flaps using Thermographic Camera

Objective: To evaluate the early detection of vascular obstruction in microvascular flaps using a thermographic camera. Study Design: A cross-sectional study. Place and Duration of the Study: Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Centre, Lahore, Pakistan, from July to December 2023. Methodology: Microvascular flaps with cutaneous islands were monitored postoperatively with a thermographic camera in addition to conventional clinical methods. The decision to re-explore was based on conventional methods, and confirmation was achieved through intraoperative findings of vascular obstruction during re-exploration. Results: Thirty-one patients who underwent microvascular surgery were monitored postoperatively with a thermographic camera. There were 20 (64.5%) anterolateral thigh flaps, 4 (12.9%) radial forearm flaps, 3 (9.7%) scapular-parascapular flaps, 1 (3.2%) medial plantar flap, 1 (3.2%) myocutaneous gracilis flap, 1 (3.2%) latissimus dorsi (LD) flap, and 1 (3.2%) chimeric adductor longus and gracilis flap. Three (9.7%) flaps developed postoperative vascular obstruction. The thermographic camera detected complications two to four hours earlier than conventional methods, with a statistically significant difference (p >0.109). Conclusion: A thermographic camera is a valuable, non-invasive, and simple tool for monitoring microvascular flaps. It can detect complications several hours earlier and has the potential to be a practice-changing modality.