Dynamic infrared mapping of cutaneous perforators

Perforator flaps have become the “gold standard” for most reconstructive procedures, replacing the conventional axial and musculocutaneous flaps. However, these flaps are a lot harder to harvest, much of the difficulty being attributable to correctly identifying and dissecting the ideal perforator in each case. Therefore, preoperative perforator mapping has become an integral part of the reconstructive protocol in many institutions. Many different imaging techniques are currently used for perforator mapping, however, they all have drawbacks, whether its exposure to radiation, high costs or operator dependence. Dynamic infrared thermography (DIRT) is a fairly new imaging technique, showing promising results, in preoperative perforator mapping, intraoperative perfusion assessment and postoperative flap monitoring. The technique is safe, fast, noninvasive, cost effective and reliable.