Effect of cooling and warming on thermographic imaging of the perforating vessels of the abdomen

The skin islands of musculocutaneous flaps are nourished by perforating arteries. An easy method for accurately locating these vessels preoperatively would be valuable in flap design. Thermography is being developed in our center as a tool to locate the perforating vessels, which appear as “hot spots” on thermographic images. The abdominal perforators of 16 women were mapped out after warming or cooling the skin with COLDI-micro thermocushions. In group I ( n =8) the thermo packs were applied to the lower abdominal skin for 30 s and in group II ( n =8) for 300 s. In both groups all hot spots disappeared after warming. After cooling, the hot spots were clearer and more readily visible than at room temperature. The longer cooling time (300 s) gave a 3.4 times better contrast ( p =0.03) than the shorter cooling time (30 s). The longer the cooling time, the longer the hot spots were visible. This work shows that cutaneous perforators can be sharply mapped preoperatively using thermography after simple bed-side cooling.