Establishment of Safety of Hemostatic Net Application Utilizing Laser Assisted Fluorescence Angiography with SPY-Q Software Analysis.

Abstract

The hemostatic net, which was initially described as a method to decrease hematoma rates in face/neck lift procedures, has since increased in practice and applicability. However, despite its demonstrated safety and efficacy, there exists significant skepticism with regards to its necessity; in particular, there is concern that the transcutaneous sutures may restrict dermal perfusion. The goal of this study was to assess flap perfusion, both pre- and post- the application of the hemostatic net, to determine if there is an objective decrease in tissue perfusion in relation to application of the hemostatic net, as measured by laser-assisted angiography (LAA). Eight patients underwent cervicofacial flap reconstruction of cutaneous malignancy defects, after which a hemostatic net was applied. All patients underwent evaluation with LAA both pre- and post- the application of the net. The average relative and absolute perfusion of different zones of the flap were calculated. The average absolute change in relative perfusion was +6.41%, +0.31%, and +3.28% for zones 1, 2, and 3, respectively, after application of the hemostatic net. There was no statistical difference in relative tissue perfusion after application of the net. There were no instances of delayed healing, infections, ischemia, necrosis, or hematoma. One patient developed a seroma after the net was removed. No patients had scarring or residual track marks from the transcutaneous sutures. With the use of LAA, we were able to objectively demonstrate no significant decrease in tissue perfusion after the application of the hemostatic net.