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Background: Perforator mapping is a mandatory tool for the preoperative planning of a microsurgical free flap, especially in breast reconstruction. Numerous methods for mapping have been described. In this study, we investigate the combined use of Dynamic Infrared Thermography (DIRT) and Colour Doppler Ultrasonography (CDUS) only to see whether it can eliminate the need for Computed Tomography Angiography (CTA). Methods: A prospective study was conducted on 33 patients with deep inferior epigastric perforator (DIEP) flaps for breast reconstruction. DIRT, followed by CDUS and CTA, was performed preoperatively and perforators were confirmed intraoperatively. Results: From 135 hot spots found on DIRT, 123 perforators were confirmed by CDUS (91.11%). A total of 86.66% of the perforator vessels detected on CTA have their correspondent on DIRT, while 95.12% have their correspondent on CDUS. No statistically significant difference (p > 0.05) was found comparing DIRT vs. CTA and CDU vs. CTA. The average DIRT time was 121.54 s and CDUS 232.09 s. The mean sensitivity for DIRT was 95.72% and 93.16% for CDUS. Conclusion: DIRT combined with CDUS can precisely and efficiently identify suitable perforators without the need for CTA in DIEP breast reconstruction.
RESUMEN
Introduction: In the context of the Coronavirus Disease (COVID-19) pandemic, the extent of the damage in the worldwide population and health systems forced governments to find rapid and efficient countermeasures. Thus, global efforts are made to combat this disease and among the identified possible solutions to enforce the frontline workforce is to allow medical and nursing students to help in medical care. This survey proposes to assess the Romanian students' self-perceived preparedness, considering their theoretical and practical knowledge. Methods: The survey was based on an 11-item form which aimed to evaluate the preparedness of the students to efficiently protect against the COVID-19 infection in a hospital setting, the overall willingness of the students to volunteer and the possible barriers that might prevent their involvement. For this purpose, a total number of 1021 responders, from which 18% nursing students and 82% medical students, from public and private medical schools of Romania, were included. Data processing was made using a free trial of GraphPad PRISM 8.0. The calculated parameters were: mean value, standard deviation, and confidence intervals (CI) and the level of significance was P<0.05. Results: Based on the collected data, we evidenced that the majority of the respondents (93%) acknowledged practical skills as a main positive factor for the decision to join the healthcare frontline. A strong, positive correlation between the self-perceived practical skills level, preparedness and the willingness to voluntarily involve in medical assistance was found. Conclusion: A significantly high level of practical skills and preparedness level in self-protecting effectively against COVID-19 was mainly seen in the following subgroups: the nursing students and the students that had previously been part of organized medical volunteer structures, revealing the practical experience to be a determining factor of preparedness.