Burn depth estimation using indocyanine green fluorescence

Green, H. A.

doi:10.1001/archderm.128.1.43

Cited by 23 publications

(13 citation statements)

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“…In addition to the direct effect of the heat, multiple complex mechanisms result in further tissue injury after a burn [3,6,7,10]. The ischemic condition that results from skin flap elevation may also progress due to various biochemical events [8,11,12,13].…”

Section: Discussionmentioning

confidence: 99%

The use of superficial and deep partial-thickness burned tissue for flap fabrication

Borman¹,

Maral

Bilezikçi

et al. 2002

European Journal of Plastic Surgery

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When flaps are indicated for early wound closure in extensive burns, and there is limited unburned local tissue to design these, one option may be to use a partial-thickness burned area as a flap for construction in the acute phase. This study examined the proportions of superficial and deep partial-thickness burned skin that can safely be included in an island flap. Eighty male Wistar rats were divided into four groups, with varying extent of burning of the right epigastric flap site: group 1, 50% superficially burned; group 2, 100% superficially burned; group 3, 50% deeply burned; and group 4, 100% deeply burned. In each group the left epigastric flaps served as controls. The superficially burned flaps in groups 1 and 2 healed at 2-4 weeks, and the deeply burned flaps in groups 3 and 4 healed at 4-6 weeks postoperatively. In all cases hair grew on the burned flap sites, and the flaps healed in such a way that they were almost impossible to distinguish, even after the hair was shaved at week 8. It was observed that the superficially burned flaps healed perfectly without scarring, but small portions of the deeply burned flaps developed scars. In conclusion, superficially and deeply burned island flaps survived completely in this animal model, even when the entire flap surface was burned. In the future, under appropriate conditions the transfer of partial-thickness burned tissue as flaps may provide a good alternative for reconstruction of the acute burn wound.

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Section: Discussionmentioning

confidence: 99%

The use of superficial and deep partial-thickness burned tissue for flap fabrication

Borman¹,

Maral

Bilezikçi

et al. 2002

European Journal of Plastic Surgery

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“…50 The most recent fluorescent dye to be studied is indocyanine green. Initially described for assessment of burn depth in an animal model in 1992 by Green et al, 51 the initial animal 52,53 and human trials 54,55 have shown potential value. The fact that the contrast is extravasated in the period of capillary leak 56 limited clinical application initially, although a recent report suggests improved detection capabilities with indocyanine green video angiography.…”

Section: Vital Dyesmentioning

confidence: 99%

Critical Review of Burn Depth Assessment Techniques: Part I. Historical Review

Jaskille

Shupp

Jordan

et al. 2009

Journal of Burn Care & Research

116

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The assessment of burn depth, and as such, the estimation of whether a burn wound is expected to heal on its own within 21 days, is one of the most important roles of the burn surgeon. A false-positive assessment and the patient faces needless surgery, a false-negative one and the patient faces increased length of stay, risks contracture, and hypertrophic scar formation. Although many clinical signs can aid in this determination, accurate assessment of burn depth is possible only 64 to 76% of the time, even for experienced burn surgeons. Through the years, a variety of tools have become available, all attempting to improve clinical accuracy. Part 1 of this two-part article reviews the literature supporting the different adjuvants to clinical decision making is, providing a historical perspective that serves as a framework for part 2, a critical assessment of laser Doppler imaging.

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“…Previous authors have reported the use of ICG fluorescence in burn wound assessment in both experimental [8,28] and clinical [29,33] studies. ICG fluorescence has been consistently shown to produce an image of the perfusion of the viable dermis and the subcutis, allowing differentiation of spontaneously healing second-degree burns from burn wounds that require excision and grafting [29,33].…”

Section: Determination Of Burn Depthmentioning

confidence: 99%

“…Early differentiation between superficial and deep burns [8], perioperative recognition of compromised microcirculation of axial and random pattern skin flaps [30], and regular detection of arterial or venous occlusion of microsurgical flaps [19] can definitively lower morbidity and enhance the rationale and quality of treatment provided to patients. Other applications include the postoperative monitoring of replanted digits in replantation surgery [37], the prediction of extremity viability, and the selection of amputation levels in patients with high voltage injury or with peripheral vascular disease [35].…”

Section: Introductionmentioning

confidence: 99%

Laser-induced fluorescence of indocyanine green: plastic surgical applications

et al. 2003

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The objective assessment of tissue perfusion is of utmost importance to plastic surgeons. Nevertheless, clinical observation remains the accepted gold standard for assessment of microcirculation. Dynamic laser fluorescence videography is a new technique for objective assessment of blood flow. We describe our clinical experience using this technique in plastic surgical patients. Possible implementations include evaluation of pedicle (random and axial pattern) flaps, monitoring of free tissue transfer and replants, and the objective determination of burn depth. Compared with standard clinical assessment techniques indocyanine green imaging provides significant additional information which allows a rational and evidence-based planning of surgery.

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Burn depth estimation using indocyanine green fluorescence

Cited by 23 publications

References 0 publications

The use of superficial and deep partial-thickness burned tissue for flap fabrication

The use of superficial and deep partial-thickness burned tissue for flap fabrication

Critical Review of Burn Depth Assessment Techniques: Part I. Historical Review

Laser-induced fluorescence of indocyanine green: plastic surgical applications

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