P-151 ROLE OF INDOCYANINE GREEN TO MITIGATE WOUND COMPLICATIONS IN ANTERIOR COMPONENT SEPARATION TECHNIQUE FOR VENTRAL HERNIA REPAIR- OUR EARLY EXPERIENCE

Abstract

Abstract Aim The subjective ease of anterior component separation technique (ACST) has made it a widely used surgical option amongst budding surgeons for ventral hernia repairs (VHR). However, surgical site occurrences (SSO) like flap necrosis due to compromised perfusion have frequently been reported. This study aims to evaluate the impact of adoption of indocyanine green-fluorescence angiography (ICG-FA) to map soft tissue perfusion on wound-related complications following open ACST in VHR. Material & Methods We performed a retrospective review of patients who underwent VHR with open ACST at a single centre between March 2018 and July 2020. The study comprised of consecutive cases of ACST with onlay meshplasty done before (March 2018–April 2019, n=24) and after (May 2019 to July 2020, n=19) implementation of ICG-FA for intra-operative perfusion mapping of subcutaneous tissue and skin. Results The pre-ICG group and post-ICG group were similar in terms of baseline patient demographics and peri-operative details. The rate of SSO was higher in the pre-ICG group, but this result was not statistically significant (46% vs. 26%; p value 0.189). Skin necrosis, however, was observed in significantly less number of patients in the post-ICG cohort (29% vs. 5%; p value 0.045). No mesh infection was observed in either group. Conclusion This study demonstrates the effectiveness of perfusion mapping by the use of ICG-FA to determine potential areas of decreased perfusion and thereby minimize wound complications.