Indocyanine green fluorescence in the assessment of the quality of the pedicled intercostal muscle flap: a pilot study†

Abstract

Our preliminary results confirmed the simplicity and high efficacy of ICG in the assessment of intercostal muscle blood perfusion. ICG was superior to macroscopic evaluation and influenced surgical proceeding.

Optimizing Indocyanine Green Fluorescence Angiography in Reconstructive Flap Surgery: A Systematic Review and Ex Vivo Experiments

“…Forty-nine articles, including 1996 surgical flaps, were selected for the review. Study designs included prospective cohort studies (n = 27), 31,34,35,38,39,[41][42][43][47][48][49][50]56,[58][59][60][62][63][64][65][66][67][68][69][70][71] retrospective cohort studies (n = 16), [25][26][27]29,32,33,36,40,44,45,51,55,57,61,72 prospective pilot studies (n = 3), 28,37,52 and retrospective case series (n = 3). 46,53,54 No randomized controlled trials have been performed yet that concern ICGA in plastic and reconstructive flap surgery.…”

“…Indocyanine green angiography has been reported for several types of flaps in plastic and reconstructive flap surgery in a clinical setting. The majority of included articles used ICGA to assess tissue perfusion of mastectomy skin flap (n = 14) intraoperatively 25,26,[31][32][33][39][40][41]47,51,55,57,58,61 ; the remainder focused on the intraoperative assessment of nipple-areolar complex perfusion, 27,72 a combination of nipple-areolar complex and mastectomy skin flap perfusion, 24 anterolateral thigh flap, 28,29 deep inferior epigastric perforator flap, 38,56,66 transverse rectus abdominis myocutaneous flap, 38,56,70 superficial inferior epigastric artery flap, 64,65,73 superficial circrumflex iliac artery flap, 50 free pericranial flap, 36 latissimus dorsi flap, 34 free parascapular flaps, 63 paramedian forehead flap, 43 intercostal muscle flap, 52 osseus free flaps, 44 free fibula flap, 45 and various pedicled and/or free flaps. 30,35,37,42,46,48,53,54,59,…”

Application of Indocyanine Green in Flap Surgery: A Systematic Review

“…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.…”

“…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).…”

Indocyanine green fluorescence/thermography evaluation of intercostal muscle flap vascularization

“…Previously, the blood supply of an IMF has only been evaluated by ICG-FL. 23 In this study, the blood supply of the IMF was evaluated intraoperatively using two different modalities, ICG-FL and thermography, to determine the adequacy of the blood supply of IMFs harvested during the same surgical procedure. We also determined whether a blood supply evaluation could be performed using thermography, which is a less invasive modality.…”