Effectiveness of intraoperative indocyanine-green fluorescence angiography during inguinal lymph node dissection for skin cancer to prevent postoperative wound dehiscence

Furukawa, Hiroshi; Hayashi, Toshihiko; Oyama, Akihiko; Funayama, Emi; Murao, Naoki; Yamao, Takeshi; Yamamoto, Yuhei

doi:10.1007/s00595-014-0996-z

Cited by 10 publications

(7 citation statements)

References 16 publications

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“…Over the years, different methods have been described for flap vitality evaluation both in gynecologic and plastic surgery. Oliver et al ( 21 ) with orthogonal polarization imaging, Furukawa et al ( 22 ) with indocyanine-green fluorescence angiography, and Zhu et al ( 23 ) via diffuse reflectance spectroscopy reported the reproducibility of different techniques to assess skin flap vascularity. Unfortunately, all of these methods require expensive machinery, often missing in common gynecological clinics.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Vulvar Flap Viability Evaluation With Near-Infrared Probe and Indocyanine Green for Vulvar Cancer Reconstructive Surgery: A Feasible Technique

et al. 2021

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Introduction: Vulvar cancer is a rare condition affecting older women and accounts for 3–5% of all gynecological cancers. Primary surgical treatment involves the removal of a large amount of tissue for which reconstructive surgery is often necessary with a high rate of postoperative complications. Despite several techniques for the evaluation of vulvar flap viability have been proposed, many methods cannot be performed during surgery and require expensive devices often missing in a gynecological clinic. This study aims to verify the feasibility and the safety of the vulvar flap viability evaluation through a near-infrared endoscopic probe and Indocyanine green (ICG) tracer in a small group of patients and to evaluate long-term vulvar flap outcomes.Methods: Patients with primary vulvar cancer who required surgical treatment and subsequent vulvar flap reconstructive surgery were prospectively included in the study. A 25 mg ICG vial diluted in 20 ml of saline solution was intravenously infused before closing the skin edges of the flaps. All patients were given 0.2 mg/kg body weight of intravenous ICG. After 10–15 min, a near-infrared endoscopic probe was used to evaluate the vulvar flap viability.Results: Of the 18 patients who underwent radical vulvectomy for vulvar cancer during the study period, 15 were included in the analysis. All packaged surgical flaps showed tracer uptake on the surgical margin. No intro-operative complications were recorded neither surgery-related nor to dye infusion. No surgical infection, dehiscence, or necrosis was recorded.Conclusions: Vulvar flap viability assessment using Indocyanine green and a laparoscopic infrared probe is a feasible method. All cases included in the analysis showed a dye uptake on the surgical edge of the flap. Further, prospective studies are needed to confirm the method in clinical practice and to evaluate its superiority over simple subjective clinical evaluation.

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Section: Discussionmentioning

confidence: 99%

Subcutaneous Vulvar Flap Viability Evaluation With Near-Infrared Probe and Indocyanine Green for Vulvar Cancer Reconstructive Surgery: A Feasible Technique

et al. 2021

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“…It has been used extensively by surgeons in the operating room. [36][37][38][39][40] Recent publications have reported its use for HBO 2 patients with soft tissue radionecrosis, 41,42 and for assessing perfusion in chronic wounds being treated with HBO 2 . 43 While this is a very promising tool, there is more work that needs to be done to determine clinical decisionmaking parameters surrounding ICGA.…”

Section: Defining the Chronic Problem Woundmentioning

confidence: 99%

<p>Hyperbaric oxygen therapy for the management of chronic wounds: patient selection and perspectives</p>

Huang¹,

Heyboer²,

Savaser³

2019

CWCMR

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The Undersea and Hyperbaric Medical Society includes "select problem wounds" as an accepted indication for the use of hyperbaric oxygen (HBO 2 ), however, the treatment of diabetic foot ulcers (DFUs) has dominated any discussions of problem wounds because of the prevalence of DFUs in today's patient population and the reimbursement available for their treatment. Other wound types (eg, calciphylaxis ulcers, sickle cell ulcers, and pyoderma gangrenosum) that have well-deserved reputations as problem wounds have been infrequently treated with HBO 2 . While there are sound fundamental reasons why additional oxygen may have benefits in the treatment of these wounds, the challenge is finding enough high quality evidence to support routine use of HBO 2 .

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“…High tension not only Delayed flaps 1 2 Lee et al 49,84 Forehead flaps induces scar hyperplasia but also reduces perfusion in the wound. 32,33 Wyles et al 32 applied intraoperative ICG fluorescent angiography to seven cases of wound closure. Wound closures, which showed evidence of ischemia caused by undue tension, were relieved by modification of suture placement.…”

Section: Intraoperative Evaluation Of Microcirculation Perfusion In Wmentioning

confidence: 99%

“…We found 29 articles introducing a potential dosing protocol for ICG (►Fig. 2), 1,11,16,21,22,[26][27][28][29][31][32][33]35,39,[44][45][46][47][48][49][50][51][52][53][54][55][56] and a total dose of 12.5 mg was the most frequently used intravenous dose. The second and third most frequently used intravenous doses were 7.5 mg total and 0.5 mg/kg (weight) , respectively.…”

Section: The Security Of Applying Icg In Flap Surgerymentioning

confidence: 99%

“…A severe adverse reaction involved cardiac, respiratory, and neurologic systems. 5,58 We have found 74 articles referring to the application of ICG fluorescence imaging in flap surgery of which, 87.8% (65 cases) did not mention preoperative allergy testing 8,10,12,16,17,[19][20][21][22][23][24][25][26]29,30,32,33,35,39,42,44,45,[47][48][49][50][51][52][54][55][56] ; 9.5% (7 cases) only reported preoperative iodine allergy test 26,28,46,53,[94][95][96] ; and 2.7% (2 cases) conducted both an iodine allergy test and ICG allergy test 5,57 (►Fig. 3).…”

Section: Adverse Reactions Preoperative Allergy Testing and Contrainmentioning

confidence: 99%

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Application of Indocyanine Green in Flap Surgery: A Systematic Review

Zhang

Nicoli

et al. 2017

J reconstr Microsurg

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ICG fluorescence imaging preoperatively facilitates the detection of perforators in tissue flaps with thickness <20 mm, aids in the evaluation of flap microcirculation and perfusion, and allows surgeons to select dominant cutaneous nerves while evaluating the quality of vascular anastomoses and locating thromboses. The literature also concluded that potential allergic reactions to ICG should be taken into consideration.

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Effectiveness of intraoperative indocyanine-green fluorescence angiography during inguinal lymph node dissection for skin cancer to prevent postoperative wound dehiscence

Abstract: Although this was a small case series, intraoperative intervention based on ICG fluorescence angiography was effective for preventing postoperative wound dehiscence after ILND.

Cited by 10 publications

References 16 publications

Subcutaneous Vulvar Flap Viability Evaluation With Near-Infrared Probe and Indocyanine Green for Vulvar Cancer Reconstructive Surgery: A Feasible Technique

Subcutaneous Vulvar Flap Viability Evaluation With Near-Infrared Probe and Indocyanine Green for Vulvar Cancer Reconstructive Surgery: A Feasible Technique

<p>Hyperbaric oxygen therapy for the management of chronic wounds: patient selection and perspectives</p>

Application of Indocyanine Green in Flap Surgery: A Systematic Review

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