Abstract
Inadequate tissue perfusion is a key contributor to early complications following reconstructive procedures. Accurate and reliable intraoperative evaluation of tissue perfusion is critical to reduce complications and improve clinical outcomes. Clinical judgment is the most commonly used method for evaluating blood supply, but when used alone, is not always completely reliable. A variety of other methodologies have been evaluated, including Doppler devices, tissue oximetry, and fluorescein, among others. However, none have achieved widespread acceptance. Recently, intraoperative laser angiography using indocyanine green was introduced to reconstructive surgery. This vascular imaging technology provides real-time assessment of tissue perfusion that correlates with clinical outcomes and can be used to guide surgical decision making. Although this technology has been used for decades in other areas, surgeons may not be aware of its utility for perfusion assessment in reconstructive surgery. A group of experts with extensive experience with intraoperative laser angiography convened to identify key issues in perfusion assessment, review available methodologies, and produce initial recommendations for the use of this technology in reconstructive procedures.
Highlights
One of the fundamental causes of early complications following reconstructive procedures is considered to be inadequate tissue perfusion [1,2,3,4,5,6]
Technologies Inc., Richmond, British Columbia, Canada) convened a summit to develop a review describing the current state of the art of evaluation of tissue perfusion in reconstructive surgery
Of 5 patients with poor flap perfusion on indocyanine green (ICG) imaging, 4 developed necrosis and 1 blistering in a pattern predicted by ICG; necrosis rate of 6.3% vs. published rates of 15-25%
Summary
One of the fundamental causes of early complications following reconstructive procedures is considered to be inadequate tissue perfusion [1,2,3,4,5,6]. Accurate and reliable intraoperative evaluation of tissue perfusion is critical to reduce complications and improve clinical outcomes. Clinical judgment is the most widely used method for evaluating blood supply [7], but by itself is not always completely reliable for assessment of flap perfusion [8,9]. Several technologies to assess tissue vascularity have been evaluated in studies and used clinically, but none have achieved universal acceptance [6,10]. Intraoperative laser angiography using indocyanine green (ICG) is a vascular imaging methodology that can be used in the intraoperative or postoperative setting to. ICG intraoperative →Visualize perforator laser angiography* perfusion zone in real time. →Confirm perfusion of tissue prior to incision, after elevation of flaps, and prior to final closure
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
