Accuracy of thermal imaging camera in identification of perforators

Abstract

Objective: To determine the diagnostic accuracy of thermal imaging camera in the identification of perforators using peroperative visual inspection as gold standard. Study Design: Descriptive study. Place of Study: Jinnah Burn and Reconstructive Surgery Centre/Allama Iqbal Medical College, Lahore, from October 2017 to September 2018. Methodology: Patients undergoing pedicled or free perforator flap for reconstructive surgery of upper and lower limb, abdomen, groin, and head and neck region, where soft tissue defect was caused by trauma (road traffic accidents and electric burns), were included in this study. All patients underwent the same treatment protocol of identification of perforator location with Flir One camera preoperatively. Later, it was confirmed peroperatively by visual inspection. Diagnostic accuracy was calculated in terms of sensitivity, specificity, positive predictive value, and negative predictive value. Results: Diagnostic accuracy in identification of perforators in pedicled (n=154) and free flaps (n=30) by thermal imaging camera was calculated as sensitivity of 86.2%, specificity of 80.0% with the positive and negative predictive values of 98.7%, and 25.0%, respectively. Conclusion: Flir One, a smartphone-compatible miniature thermal imaging camera, is useful for the detection of perforators and is highly sensitive and specific.