Serial Static Infrared Thermography for Intraoperative and Postoperative Surface-Temperature Monitoring of Free-Flap Skin Islands in Paediatric Craniofacial Reconstruction: A Technical Feasibility Study

Background/Objectives: This single-patient retrospective study evaluated the technical feasibility of serial infrared thermography (IRT) for intraoperative and postoperative surface-temperature documentation of free-flap skin islands and its descriptive concordance with clinical and vascular assessments.

Methods

A 9-year-old boy with Nager syndrome undergoing bilateral temporomandibular joint reconstruction and soft-tissue reconstruction with an anterolateral thigh free flap divided into two skin islands was monitored intraoperatively and postoperatively. Thermograms were acquired using a FLIR T1020 camera (emissivity 0.98) under documented environmental conditions. Intraoperative and postoperative observations were interpreted separately, without normalisation between settings. Mean temperatures within manually delineated regions of interest and inter-island differences were analysed retrospectively and compared descriptively with documented clinical assessment, Doppler ultrasonography, and computed tomography angiography (CTA) findings.