The perfusion code of DIEP and ms-TRAM flaps is a hard nut to crack

We read with interest the article by Ludolph et al. entitled “Cracking the perfusion code?: Laser-assisted Indocyanine Green angiography and combined laser Doppler spectrophotometry for intraoperative evaluation of tissue perfusion in autologous breast reconstruction with DIEP or ms-TRAM flaps”.1 We completely agree with the authors that intraoperative evaluation of flap perfusion can still be challenging. Such is especially true in those cases where flaps are composed of several angiosomes as is usually the case with the DIEP and ms-TRAM flaps.

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