Figure 3.

Thermal imaging of a DIEP flap raised in the supra-muscular fascia plane with only 3 perforators left attached. Microvascular clamps were used to clamp the perforators until the flap showed no heated/perfused areas, then one perforator was unclamped each time and the pattern of perfusion was recorded giving an idea about the effect of each perforator on the flap perfusion. A: The three arrows pointing to the location of the perforators before clamping. B: P1 perforator was unclamped and the pattern of perfusion was captured. C: P1 perforator was re-clamped and P2 perforator was unclamped. The pattern of flap perfusion was then captured again. D: P1 and P2 were clamped and P3 unclamped. Notice the flap perfusion on thermal imaging is best when based on P3. This was corresponding to the clinical findings which meant that P3 was the dominant perforator and the decision was made to raise the flap based on it.