Application of indocyanine green SPY imaging in flap surgery / 中华整形外科杂志

ABSTRACT

Objective@#To evaluate the efficacy of indocyanine green SPY imaging in flap surgery.@*Methods@#Between July 2016 and March 2017, forty-five flaps of thirty-five consecutive patients were retrospectively analyzed, among which forty-four were pedicled flaps and one was free flap, measuring from 2.0 cm×1.5 cm to 34.0 cm×17.0 cm. SPY imaging was performed twice for each flap, after the elevation of flap and after flap insertion respectively. The correlation of the flap perfusion detected by SPY and the prognosis of each flap were recorded and analyzed.@*Results@#Twenty-nine flaps demonstrated good perfusion on SPY healed uneventfully. Sixteen flaps were demonstrated poor perfusion in the distal part of flap. Two flaps underwent surgical intervention intraoperatively and totally survived. Fourteen flaps were preserved conservatively and nine suffered partial- or full-thickness necrosis. None of the remaining five flaps sustained necrosis. Secondary healing was achieved through regular dressing change or operative debridement. The sensitivity, specificity and accuracy were 100%(9/9), 85.3%(29/34) and 88.4%(38/43) respectively.@*Conclusions@#Intraoperative indocyanine green SPY imaging is a useful adjuvant to evaluate flap perfusion and predict necrosis in plastic surgery, enhancing a surgeon’s clinical judgment of flap viability.