Evidence map›Paper›PMID 41479636›Full record

ReviewJPRAS open2026

Dynamic infrared thermography in free flap surgery: A systematic review.

Warre Clarys, Valentine Hotome, Stefan Hummelink, Simon Verspeek, Veronique Verhoeven, Wiebren A A Tjalma, Gunther Steenackers, Filip Thiessen

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Warre ClarysUniversity of Antwerp, InViLab Research Group, Groenenborgerlaan 171, Antwerp, B-2020, Belgium.
Valentine HotomeFaculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, Antwerp, B-2610, Belgium.
Stefan HummelinkRadboud University Medical Center, Department of Plastic Surgery, Geert Grooteplein Zuid 10, Nijmegen, 6525 GA, The Netherlands.
Simon VerspeekUniversity of Antwerp, InViLab Research Group, Groenenborgerlaan 171, Antwerp, B-2020, Belgium.
Veronique VerhoevenDepartment of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, Wilrijk, B-2610, Belgium.
Wiebren A A TjalmaDepartment of Obstetrics and Gynaecology, Multidisciplinary Breast Clinic, Gynaecological Oncology Unit, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, Edegem, B-2650, Belgium.
Gunther SteenackersUniversity of Antwerp, InViLab Research Group, Groenenborgerlaan 171, Antwerp, B-2020, Belgium.
Filip ThiessenDepartment of Plastic, Reconstructive and Aesthetic Surgery, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, Antwerp, B-2650, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Dynamic infrared thermography (DIRT) is increasingly being utilized for perforator selection and perfusion assessment in reconstructive microsurgery, particularly in procedures such as deep inferior epigastric perforator (DIEP) flap reconstructions. This systematic review evaluates the current evidence regarding the diagnostic performance, clinical applicability, and recent advancements of DIRT in free flap surgery. Methods: A systematic search was conducted in accordance with PRISMA guidelines across the PubMed, Scopus, and Web of Science databases, including studies published up to December 2024. Inclusion criteria comprised primary studies employing DIRT in free flap surgery using a dynamic cold challenge, while static thermography experiments were excluded. Data on study characteristics, diagnostic accuracy, and recent technological developments were extracted and assessed using the QUADAS-2 tool. Results: A total of 31 studies were included, ranging from case reports to prospective cohort studies. DIRT demonstrated sensitivities between 84 % and 95 % for perforator detection, comparable to computed tomography angiography (CTA) and superior to hand-held Doppler (HHD). Despite limitations such as lower resolution and shallow detection depth, recent innovations, including augmented reality (AR), smartphone integration, and artificial intelligence (AI), offer promising solutions for enhanced reliability and user-friendliness. Conclusion: DIRT is an effective, non-invasive technique with diagnostic accuracy comparable to CTA for preoperative and intraoperative perforator selection in free flap surgery. Further standardization and large-scale clinical studies are warranted to establish DIRT as a standard diagnostic tool in reconstructive microsurgery.

Indexed as

Augmented realityDIEP flapDynamic infrared thermographyFlap monitoringFree flap surgeryPerforator mapping

Identifiers

PMID41479636
PMCPMC12754218

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.