Infrared thermography as an adjunct to ICG (IndocyanineGreen) angiography for the assessment of perfusion in DIEP(Deep Inferior Epigastric Perforator) flaps: a pilot study ofcorrelation and concordance

Background: loss of tissue perfusion and fat necrosis in DIEP (Deep Inferior Epigastric Perforator) flap econstruction, secondary to hypoperfusion, remains a cause of morbidity. ICG (Indocyanine Green) angiography is the current gold standard for intraoperative assessment but may overestimate ischemia. imilarly,infrared thermography technologies can estimate the risk of necrosis and perfusion success. However, their combined use has not been studied. The objective of this study was to evaluate the correlation and concordance etween the thermographic hotspot and ICG angiography. Materials and methods: a pilot study was conducted on 12 patients undergoing breast reconstruction with a DIEP flap. Intraoperatively, flap perfusion was assessed with thermography using a thermal camera, and with ICG using the SPY-Q software scale. Results: dual verification with ICG and the thermographic hotspot allowed for the detection of one case (8.7 %) with immediate postoperative ischemia that required a new arterial anastomosis.At the 12-month follow-up, the patient presented no major complications. The correlation between both technologieswas significant for zones I and III p