Abstract
BackgroundIndocyanine green (ICG) angiography has proven useful in assessing skin flap perfusion in plastic and reconstructive surgeries. This research aimed to explore its role in decision making about skin-sparing in children's acute trauma.MethodsA total of 19 patients suffering with acute trauma from January 2019 to September 2021 were retrospectively assessed. Both ICG angiography and clinical judgment were performed to evaluate skin tissue viability. The intraoperative decisions for each case depended on the specific condition of the traumatic wound, including tissue perfusion, skin defect area, and location of the wound. Postoperative vascular imaging software was used to quantify the tissue perfusion, and the duration of postoperative follow-up was from 6 to 18 months.ResultsAmong them, 18 (94.7%) patients experienced treatments according to ICG angiography and did not develop postoperative necrosis. One case with right forearm trauma suffered from partial necrosis. Hypertrophic scar and local infection were the independent complications, which were managed by symptomatic treatment.ConclusionICG angiography may reduce the risk of postoperative necrosis and renders a promising adjunctive technique for surgeons to make reasonable decisions in skin sparing in acute pediatric trauma.
Highlights
The evaluation of skin tissue viability is the key to the management of children’s acute trauma and is generally associated with the prognosis of local appearance or function [1, 2]
An increasing amount of research focuses on the application of indocyanine green (ICG) angiography in both burn depth estimation and precise marking for burn
Precise marking for tissue with hypoperfusion was shown by excision ICG angiography
Summary
The evaluation of skin tissue viability is the key to the management of children’s acute trauma and is generally associated with the prognosis of local appearance or function [1, 2]. Decision making about skin sparing is a test for young surgeons, especially in cases of laceration or avulsion injury, that create a state of vasoconstriction intraoperatively [3, 4]. Intraoperative indocyanine green (ICG) angiography has been widely used in assessing skin flap perfusion in various kinds of plastic and reconstructive surgeries [5–8]. It can be an efficient adjuvant to enhance the surgeon’s judgment of skin tissue viability and significantly decrease the odds of local necrosis after flap surgery. Indocyanine green (ICG) angiography has proven useful in assessing skin flap perfusion in plastic and reconstructive surgeries. This research aimed to explore its role in decision making about skin-sparing in children’s acute trauma
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