• Bilal Umar, Hafiz Khalil Ahmad, Barira Bashir, Ammara Rabbani, Muhammad Tariq Iqbal, and Kamran Khalid.
• Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Centre, Lahore, Pakistan.
• J Coll Physicians Surg Pak. 2024 Sep 1; 34 (9): 107910831079-1083.

ObjectiveTo evaluate the early detection of vascular obstruction in microvascular flaps using a thermographic camera.Study DesignA cross-sectional study. Place and Duration of the Study: Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Centre, Lahore, Pakistan, from July to December 2023.MethodologyMicrovascular flaps with cutaneous islands were monitored postoperatively with a thermographic camera in addition to conventional clinical methods. The decision to re-explore was based on conventional methods, and confirmation was achieved through intraoperative findings of vascular obstruction during re-exploration.ResultsThirty-one patients who underwent microvascular surgery were monitored postoperatively with a thermographic camera. There were 20 (64.5%) anterolateral thigh flaps, 4 (12.9%) radial forearm flaps, 3 (9.7%) scapular-parascapular flaps, 1 (3.2%) medial plantar flap, 1 (3.2%) myocutaneous gracilis flap, 1 (3.2%) latissimus dorsi (LD) flap, and 1 (3.2%) chimeric adductor longus and gracilis flap. Three (9.7%) flaps developed postoperative vascular obstruction. The thermographic camera detected complications two to four hours earlier than conventional methods, with a statistically significant difference (p >0.109).ConclusionA thermographic camera is a valuable, non-invasive, and simple tool for monitoring microvascular flaps. It can detect complications several hours earlier and has the potential to be a practice-changing modality.Key WordsMicrovascular flaps, Thermographic camera, Vascular obstruction.

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