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

• Published in: Plastic and reconstructive surgery. Global open Vol. 7; no. 8; p. e2359
• Main Authors: Patel, Shimul S., Homsy, Christopher, Atamian, Elisa K., Chaffin, Abigail E.
• Format: Journal Article
• Language: English
• Published: United States The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons 01-08-2019; Copyright The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved; Wolters Kluwer Health
• Subjects: Case Report
• ISSN: 2169-7574; 2169-7574
• DOI: 10.1097/GOX.0000000000002359

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.