NON-INVASIVE |
NON-INVASIVE |
NON-INVASIVE |
Acoustic Doppler Sonography (HHD)
Colour-coded Duplex Sonography (DS)
|
Common and cost-effective method for locating perforators or axial
pattern flap pedicles.
DS provides a more detailed information on vessel anatomy.
|
HHD may yield false positives due to high sensitivity.
DS demands extensive anatomical knowledge, proving time-consuming and
technically challenging. DS is unable to provide three-dimensional
information about vascular anatomy.
|
Near Infrared Spectroscopy (NIRS) |
Allows non-invasive measurement of
oxygen level changes, demonstrating high accuracy in differentiating
between venous and arterial compromise in free flaps. |
Currently
lacking dedicated flap assessment systems. Higher cost than other
systems. |
Hyperspectral Imaging (HSI)
|
Provides effective real-time evaluation of tissue properties and early
detection of flap issues.
|
High-cost
No clear superiority over other techniques.
|
Thermal Imaging (TI) |
Non-invasive, low-cost, smartphone-based imaging
for early detection of vascular insults. Provides valuable postoperative
monitoring in pedicled flaps. |
Limited to surface temperature changes.
Specificity may vary. |
Photoplethysmography (PPG) |
Non-contact measurement of tissue blood
volume changes, aiding in differentiating between venous and arterial
thrombosis in free flaps. |
Requires prior visualization of vascular
anatomy for effective use during postoperative
monitoring. |
INVASIVE TECHNIQUES |
INVASIVE TECHNIQUES |
INVASIVE
TECHNIQUES |
Contrast-enhanced Ultrasound (CEUS) |
Integrates vascular ultrasound
with contrast agents, providing accuracy in locating small-lumen
perforating vessels. |
Invasive nature; may involve risks associated
with contrast agents. |
Computed Tomography Angiography (CTA) |
High accuracy, shorter
examination times, and visualization of smaller vessels. |
Involves
ionizing radiation, limiting use in certain patient
populations. |
Near-infrared Fluorescence Angiography with ICG (NIRF) |
Real-time
visualization of vessel structure, aiding in surgical planning and
predicting tissue flap survival. |
Expensive, Invasive due to
intravenous injection; potential risks associated with ICG
use. |
Implantable Doppler Probe
|
Rapid detection of compromise, especially in non-visible flaps.
|
Controversial findings regarding sensitivity and false-negative results.
May not offer advantages in all cases.
|