Vascular-controlled indocyanine green fluorescence angiography for evaluating locoregional flap perfusion prior to pedicle division

Although free-tissue transfer is widely used, locoregional flaps remain useful in reconstruction; however, they may require a secondary division procedure, and determining flap perfusion and deciding the timing of pedicle division can be challenging. Fluorescence test has been used to acquire real-time tissue perfusion images to help decide the timing of pedicle flap division.(1, 2) Technically, pedicle blood flow is temporarily obstructed using rubber bands, custom-made Orthoplast sheets, long-nose locking pliers, intestinal clamps, or a pneumatic tourniquet device to clarify whether the recipient site provides sufficient flap perfusion; (3) unfortunately, flap failure after pedicle division can still occur due to false-positive signals transmitted from the wound bed or perfusion leakage due to failed pedicle clamping.
Source: Journal of Plastic, Reconstructive and Aesthetic Surgery - Category: Cosmetic Surgery Authors: Source Type: research