title: Dynamic perfusion assessment during perforator flap surgery: an up-to-date.
abstract: Flap monitoring technology has progressed alongside flap design. The highly variable vascular anatomy and the complexity associated with modern perforator flaps demands dynamic, real-time, intraoperative information about the vessel location, perfusion patterns and flap physiology. Although most surgeons still assess flap perfusion and viability based solely on clinical experience, studies have shown that results may be highly variable and often misleading. Poor judgment of intraoperative perfusion leads to major complications. Employing dynamic perfusion imaging during flap reconstruction has led to a reduced complication rate, lower morbidity, shorter hospital stay, and an overall better result. With the emergence of multiple systems capable of intraoperative flap evaluation, the purpose of this article is to review the two systems that have been widely accepted and are currently used by plastic surgeons: Indocyanine green angiography (ICGA) and dynamic infrared thermography (DIRT).
authors.affiliation: Department of Plastic Surgery, Rehabilitation Hospital, Cluj-Napoca, Romania.
authors.forename: Maximilian Vlad
authors.initials: MV
authors.lastname: Muntean
authors.affiliation: Department of Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Valentin
authors.initials: V
authors.lastname: Muntean
authors.affiliation: Department of Plastic Surgery, Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Filip
authors.initials: F
authors.lastname: Ardelean
authors.affiliation: Department of Plastic Surgery, Rehabilitation Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Alexandru
authors.initials: A
authors.lastname: Georgescu
keywords: indocyanine green; perforator flap; thermography