研究目的
To evaluate the intraoperative blood flow of pedicled perforator flaps using indocyanine-green fluorescence angiography (ICG-FA) to determine safe flap dimensions based on a single perforator intraoperatively.
研究成果
ICG-FA can delineate areas with decreased perfusion in pedicled perforator flaps intraoperatively. When clinical findings contradict ICG-FA results, tissue resection may be withheld to allow stabilization of perfusion. Planning flaps larger than the defect is imperative in pedicled flaps.
研究不足
Small number of cases included, potential sampling bias, lack of a defined threshold value for differentiating between hypoperfused tissue progressing to necrosis and areas that will stabilize over time.
1：Experimental Design and Method Selection:
Retrospective review of patients who underwent soft tissue reconstruction with pedicled perforator flaps utilizing ICG-FA.
2：Sample Selection and Data Sources:
Five cases from January to March 2019 where clinical assessment of flap perfusion was supported by intraoperative ICG-FA.
3：List of Experimental Equipment and Materials:
Real-time laser fluorescent angiography (Spy-PHI, Stryker, Mich.), ICG (
4：1 mg/kg standard dose). Experimental Procedures and Operational Workflow:
Preoperative flap planning with a handheld Doppler device, intraoperative confirmation of perforator location, flap elevation and rotation into the defect, ICG injection to visualize flap perfusion, observation over 4 minutes to evaluate egress of ICG.
5：Data Analysis Methods:
Clinical evaluation of flap perfusion by means of capillary refill and tissue turgor, ICG-FA to visualize perfusion.
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