Thermal Imaging Facilitates Design of a Keystone Perforator Island Flap for a Myxofibrosarcoma Resection Reconstruction: Case Report

Shimul S Patel; Christopher Homsy; Elisa K Atamian; Abigail E Chaffin

doi:10.1097/GOX.0000000000002359

Thermal Imaging Facilitates Design of a Keystone Perforator Island Flap for a Myxofibrosarcoma Resection Reconstruction: Case Report

Plast Reconstr Surg Glob Open. 2019 Aug 8;7(8):e2359. doi: 10.1097/GOX.0000000000002359. eCollection 2019 Aug.

Authors

Shimul S Patel¹, Christopher Homsy¹, Elisa K Atamian², Abigail E Chaffin¹

Affiliations

¹ Division of Plastic Surgery, Tulane University Medical Center, New Orleans, La.
² Tulane University School of Medicine, New Orleans, La.

Abstract

Lower extremity defects are challenging to reconstruct. The keystone perforator island flap proves useful in difficult cases. Traditionally, a handheld Doppler is used to confirm perforator vessel(s) within the flap but has disadvantages including low sensitivity/specificity. Surgeons can use thermal imaging to localize "hot spots" on the skin, corresponding to perforators. FLIR ONE (FLIR Systems Inc., Wilsonville, OR) is a portable thermal camera with high concordance with computed tomographic angiography. In this case, when faced with handheld Doppler failure, we used intraoperative thermal imaging to continue planning and raising of a complex lower extremity keystone perforator island flap.

Publication types

Case Reports