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Foppiani et al. Plast Aesthet Res 2023;10:53 https://dx.doi.org/10.20517/2347-9264.2022.137 Page 9 of 14

Table 3. Outcomes of thermography vs. oximetry monitoring
>Complication rates Number of studies Total Prevalence [95%CI] I (%)
2
Threatened flaps
Overall 14 206/3,289 0.06 [0.03, 0.11] 91%
Thermography 3 14/95 0.10 [0.02, 0.42] 0%
Oximetry 11 192/3,194 0.05 [0.03, 0.10] 92%
Partial flap loss
Overall 14 37/3,289 0.01 [0.00; 0.03] 28%
Thermography 3 9/95 0.01 [0.00, 0.73] 0%
Oximetry 11 28/3,194 0.01 [0.00, 0.02] 100%
Complete flap loss
Overall 14 15/3,289 0.00 [0.00; 0.01] 0%
Thermography 3 0/95 0.00 [0.00, 1.00] 0%
Oximetry 11 15/3,194 0.00 [0.00, 0.01] 0%
Necrosis
Overall 8 158/1,802 0.03 [0.01, 0.12] 77%
Thermography 3 10/95 0.04 [0.00, 0.36] 60%
Oximetry 5 148/1,707 0.03 [0.01, 0.13] 78%
Congestion
Overall 8 37/1,527 0.02 [0.01, 0.04] 38%
Thermography 2 3/63 0.03 [0.00, 0.29] 0%
Oximetry 6 34/1,464 0.02 [0.01, 0.04] 25%
Hematoma
Overall 9 62/2,427 0.03 [0.02, 0.03] 0%
Thermography 2 0/63 0.00 [0.00, 1.00] 0%
Oximetry 7 62/2,364 0.03 [0.02, 0.03] 0%
Infection
Overall 6 67/1,803 0.01 [0.00, 0.13] 1%
Thermography 2 5/63 0.04 [0.00, 0.56] 0%
Oximetry 4 62/1,740 0.01 [0.00, 0.16] 0%
Return to OR
Overall 10 179/2,504 0.05 [0.02, 0.09] 87%
Thermography 2 9/95 0.01 [0.00, 0.73] 0%
Oximetry 8 170/2,409 0.05 [0.03, 0.09] 87%
Rate of salvage
Overall 10 190/3,171 0.06 [0.03, 0.11] 94%
Thermography 2 14/62 0.23 [0.14, 0.35] 12%
Oximetry 8 176/3,109 0.12 [0.05, 0.33] 94%

OR: operating room.

may have their roles as efficacious monitoring tools to identify and prompt successful interventions in
breast microvascular reconstruction. Compared to the existing literature, both sub-groups of studies
included in this meta-analysis show better outcomes for partial and complete flap loss rates. Indeed, the
literature reports partial flap loss in up to 9% of patients undergoing autologous breast reconstruction and
complete flap loss in less than 5% of patients [1-10,33,34] . If not for the postoperative monitoring in each of our
studies, it could be hypothesized that a larger proportion of patients who had partial flap failure would have
progressed to total flap failure instead. Noninvasive, postoperative monitoring of breast flaps provides
plastic surgeons a chance to identify threatened flaps before they show physical signs of distress and require