Intraoperative use of dynamic infrared thermography and indocyanine green fluorescence video angiography to predict partial skin flap loss

被引：14
作者：
Miland Å.O. [1 ]
De Weerd L. [2 ]
Mercer J.B. [1 ,3 ]
机构：
[1] Department of Medical Physiology, Faculty of Medicine, University of Tromsø
[2] Department of Plastic Surgery and Hand Surgery, University Hospital North Norway
[3] Department of Radiology, University Hospital North Norway
来源：
European Journal of Plastic Surgery | 2008年 / 30卷 / 6期
关键词：
Flap necrosis; Indocyanine green fluorescence angiography; Infrared thermography; Pedicled skin flap;
D O I：
10.1007/s00238-007-0201-3
中图分类号：
学科分类号：
摘要：
Inadequate perfusion is the most common cause of partial flap loss in reconstructive surgery. Intraoperative monitoring of flap perfusion may prevent such loss. This study compared indocyanine green fluorescence angiography (ICG-FA) and dynamic infrared thermography (DIRT) in their ability to predict intraoperatively the percentage of flap survival in a caudally based McFarlane flap in 10 male Wistar rats. The intraoperative images of both techniques were subjectively and objectively analysed. The percentage of flap survival, as judged from the digital colour photographs 7 days post-operatively, was 69±3%. Objective analysis of flap survival based on intraoperative DIRT and ICG-FA (74 vs 63%, respectively) correlated quite well with the subjective measurements (75±2 vs 59±4%, respectively). However, intraoperative ICG-FA images underestimated flap survival by 6-10%, while intraoperative DIRT images overestimated the flap survival by 5-6%. The authors conclude that intraoperative use of ICG-FA and DIRT can provide valuable information on areas with inadequate perfusion as long as their limitations are respected. © 2007 Springer-Verlag.
引用
收藏
页码：269 / 276
页数：7
相关论文
共 31 条
  • [1] Allen R.J., Heitmann C., Perforator flaps-the history of evolution, Handchir Mikrochir Plast Chir, 34, pp. 216-218, (2002)
  • [2] Benya R., Quintana J., Brundage B., Adverse reactions to indocyanine green: A case report and a review of the literature, Cathet Cardiovasc Diagn, 17, pp. 231-233, (1989)
  • [3] Briggs P.C., The McFarlane flap, Plast Reconstr Surg, 80, pp. 472-473, (1987)
  • [4] Cormack G.C., Lamberty B.G., Cormack G.C., Concepts of territories, The Arterial Anatomy of Skin Flaps, pp. 6-10, (1994)
  • [5] Daniel R.K., Kerrigan C.L., Skin flaps: An anatomical and hemodynamic approach, Clin Plast Surg, 6, pp. 181-200, (1979)
  • [6] De Weerd L., Mercer J.B., Setsa L.B., Intraoperative dynamic infrared thermography and free-flap surgery, Ann Plast Surg, 57, pp. 279-284, (2006)
  • [7] Eren S., Krein R., Hafemann B., Objective evaluation of the microcirculation in the skin with indocyanine green angiography (ICGA). a method for the clinic?, Handchir Mikrochir Plast Chir, 27, pp. 307-314, (1995)
  • [8] Francis J.E., Roggli R., Love T.J., Robinson C.P., Thermography as a means of blood perfusion measurement, J Biomech Eng, 101, pp. 246-249, (1979)
  • [9] Giunta R.E., Holzbach T., Taskov C., Holm P.S., Brill T., Busch R., Gansbacher B., Biemer E., Prediction of flap necrosis with laser induced indocyanine green fluorescence in a rat model, Br J Plast Surg, 58, pp. 695-701, (2005)
  • [10] Holm C., Mayr M., Hofter E., Becker A., Pfeiffer U.J., Muhlbauer W., Intraoperative evaluation of skin-flap viability using laser-induced fluorescence of indocyanine green, Br J Plast Surg, 55, pp. 635-644, (2002)
1234