Smartphone-based thermography in flap surgery: A systematic review and meta-analysis of perforator identification
Loïc Van Dieren,
Haïzam Oubari,
Louise Callens,
Yanis Berkane,
Tom Quisenaerts,
François Saget,
Wiebren Tjalma,
Gunther Steenackers,
Curtis L. Cetrulo Jr,
Alexandre G. Lellouch,
Filip Thiessen EF
Affiliations
Loïc Van Dieren
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Faculty of Medicine and Health Sciences, Antwerp, Belgium
Haïzam Oubari
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Louise Callens
Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
Yanis Berkane
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center, Rennes, France; Shriners Hospitals for Children, Harvard Medical School, Boston, MA, USA
Tom Quisenaerts
Faculty of Medicine and Health Sciences, Antwerp, Belgium
François Saget
Department of SAMU-SMUR-Emergencies, Rennes University Hospital Center, Rennes, France
Wiebren Tjalma
Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, B-2650, Antwerp, Belgium
Gunther Steenackers
InViLab Research Group, Department Electromechanics, Faculty of Applied Engineering, University of Antwerp, Groenenborgerlaan 171, B-2020, Antwerpen, Belgium
Curtis L. Cetrulo Jr
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Shriners Hospitals for Children, Harvard Medical School, Boston, MA, USA
Alexandre G. Lellouch
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Shriners Hospitals for Children, Harvard Medical School, Boston, MA, USA; Corresponding author. MGH / Harvard Medical School, 50 Blossom St, Boston, MA, 02114, USA.
Filip Thiessen EF
Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, B-2650, Antwerp, Belgium; Department of Plastic, Reconstructive and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, Antwerp, Belgium; Department of Plastic, Reconstructive and Aesthetic Surgery, Ziekenhuis Netwerk Antwerpen, Antwerp, Belgium
Background: Thermography can be used in pre-operative planning of free perforator flap surgeries. Thermography assesses skin temperature by measuring the quantity of infrared radiation observed. In this meta-analysis, authors assess the sensitivity of smartphone-based thermal imaging (SBTI) in the detection of perforators and analyze the difference between static and dynamic imaging. Materials and methods: Authors followed the PRISMA guidelines for systematic reviews and meta-analyses. The meta package in R was used to conduct the meta-analysis. The “metaprop” function was used to calculate the overall sensitivity estimate and 95% confidence interval. The “metaprop.one” function was used to calculate subgroup estimates for static and dynamic study types. The “metareg” function was used to conduct meta-regression analyses to explore sources of heterogeneity. Results: This study includes seven articles with 1429 perforators being evaluated. The overall proportion of the sensitivities was estimated to be 0.8754 (95% CI: 0.7542; 0.9414) using a random effects model. The heterogeneity of the studies was high, as indicated by the tau^2 value of 1.2500 (95% CI: 0.4497; 8.4060) and the I^2 value of 92.6% (95% CI: 88.1%; 95.4%). The pooled sensitivity for static imaging was 0.8636 (95%CI: 0.6238–0.9603) with a tau^2 of 2.0661 and a tau of 1.4374, while the pooled sensitivity for dynamic imaging was slightly higher (p = 0.7016) at 0.8993 (95%CI: 0.7412–0.9653) with a smaller tau^2 of 0.8403 and a tau of 0.9167. Conclusion: Further studies need to confirm that SBTI is a reliable and convenient technique for detecting perforators for the pre-operative planning of free perforator flap surgeries.
