Vascularized Osseous Flaps and Assessing Their Bipartate Perfusion Pattern via Intraoperative Fluorescence Angiography

Valerio, Ian L.; Green, J. Marshall; Sacks, Justin M.; Thomas, Shane; Sabino, Jennifer; Acartürk, Tahsin Oğuz

doi:10.1055/s-0034-1383821

Cited by 14 publications

(3 citation statements)

References 26 publications

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“…NIRF angiography, after intravenous dye administration, was reported in 32 articles. The majority ( n = 24) [ 7 , 8 , 10 , 11 , 15 , 20 – 22 , 24 , 27 , 29 , 32 , 35 , 36 , 40 – 44 , 48 – 51 ] used NIRF to assess tissue perfusion in (free) flap surgery; the remainder focused on the perioperative assessment of mastectomy skin flap perfusion [ 32 – 34 ], bone perfusion [ 37 ], abdominal wall perfusion in abdominal wall reconstruction [ 23 , 28 ], and perfusion of a composite allograft [ 25 , 38 , 39 ]. See Table 4 .…”

Section: Resultsmentioning

confidence: 99%

Near-infrared fluorescence image-guidance in plastic surgery: A systematic review

et al. 2018

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BackgroundNear-infrared fluorescence (NIRF) imaging technique, after administration of contrast agents with fluorescent characteristics in the near-infrared (700–900 nm) range, is considered to possess great potential for the future of plastic surgery, given its capacity for perioperative, real-time anatomical guidance and identification. This study aimed to provide a comprehensive literature review concerning current and potential future applications of NIRF imaging in plastic surgery, thereby guiding future research.MethodsA systematic literature search was performed in databases of Cochrane Library CENTRAL, MEDLINE, and EMBASE (last search Oct 2017) regarding NIRF imaging in plastic surgery. Identified articles were screened and checked for eligibility by two authors independently.ResultsForty-eight selected studies included 1166 animal/human subjects in total. NIRF imaging was described for a variety of (pre)clinical applications in plastic surgery. Thirty-two articles used NIRF angiography, i.e., vascular imaging after intravenous dye administration. Ten articles reported on NIRF lymphography after subcutaneous dye administration. Although currently most applied, general protocols for dosage and timing of dye administration for NIRF angiography and lymphography are still lacking. Three articles applied NIRF to detect nerve injury, and another three studies described other novel applications in plastic surgery.ConclusionsFuture standard implementation of novel intraoperative optical techniques, such as NIRF imaging, could significantly contribute to perioperative anatomy guidance and facilitate critical decision-making in plastic surgical procedures. Further investigation (i.e., large multicenter randomized controlled trials) is mandatory to establish the true value of this innovative surgical imaging technique in standard clinical practice and to aid in forming consensus on protocols for general use.Level of Evidence: Not ratable

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Section: Resultsmentioning

confidence: 99%

Near-infrared fluorescence image-guidance in plastic surgery: A systematic review

et al. 2018

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“…There have been previous reports on the use of ICG fluorescence angiography for confirmation of bone perfusion: 1 in clinical settings and the other using porcine models. 11 , 12 However, to the best of our knowledge, we found no report on the use of ICG fluorescence angiography for evaluation of bone perfusion in cadavers. Our method can be especially beneficial in confirming the bone perfusion of a new bone flap based on a particular artery, both in cadavers and in patients, because ICG can be injected into specific arteries.…”

Section: Discussionmentioning

confidence: 96%

Feasibility of Bone Perfusion Evaluation in Cadavers Using Indocyanine Green Fluorescence Angiography

Yoshimatsu

Steinbacher

Meng

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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“…Therefore, an objective tool that could effectively measure the soft tissue recovery with thresholds identified in association with appropriateness for definitive internal fixation may significantly improve the current practice. Optical imaging tools that image tissue perfusion of indocyanine green (ICG) have longstanding success regarding assessment of soft tissue viability and perfusion in the setting of plastic surgical indications such as free osseous flap perfusion 26 , 27 or breast reconstruction. 28 , 29 They are, therefore, well suited for this application.…”

Section: Potential Optical Imaging and Sensing Needsmentioning

confidence: 99%

Perspective on optical imaging for functional assessment in musculoskeletal extremity trauma surgery

et al. 2020

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. Significance: Extremity injury represents the leading cause of trauma hospitalizations among adults under the age of 65 years, and long-term impairments are often substantial. Restoring function depends, in large part, on bone and soft tissue healing. Thus, decisions around treatment strategy are based on assessment of the healing potential of injured bone and/or soft tissue. However, at the present, this assessment is based on subjective clinical clues and/or cadaveric studies without any objective measure. Optical imaging is an ideal method to solve several of these issues. Aim: The aim is to highlight the current challenges in assessing bone and tissue perfusion/viability and the potentially high impact applications for optical imaging in orthopaedic surgery. Approach: The prospective will review the current challenges faced by the orthopaedic surgeon and briefly discuss optical imaging tools that have been published. With this in mind, it will suggest key research areas that could be evolved to help make surgical assessments more objective and quantitative. Results: Orthopaedic surgical procedures should benefit from incorporation of methods to measure functional blood perfusion or tissue metabolism. The types of measurements though can vary in the depth of tissue sampled, with some being quite superficial and others sensing several millimeters into the tissue. Most of these intrasurgical imaging tools represent an ideal way to improve surgical treatment of orthopaedic injuries due to their inherent point-of-care use and their compatibility with real-time management. Conclusion: While there are several optical measurements to directly measure bone function, the choice of tools can determine also the signal strength and depth of sampling. For orthopaedic surgery, real-time data regarding bone and tissue perfusion should lead to more effective patient-specific management of common orthopaedic conditions, requiring deeper penetrance commonly seen with indocyanine green imaging. This will lower morbidity and result in decreased variability associated with how these conditions are managed.

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Vascularized Osseous Flaps and Assessing Their Bipartate Perfusion Pattern via Intraoperative Fluorescence Angiography

Cited by 14 publications

References 26 publications

Near-infrared fluorescence image-guidance in plastic surgery: A systematic review

Near-infrared fluorescence image-guidance in plastic surgery: A systematic review

Feasibility of Bone Perfusion Evaluation in Cadavers Using Indocyanine Green Fluorescence Angiography

Perspective on optical imaging for functional assessment in musculoskeletal extremity trauma surgery

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