Prediction of flap necrosis with laser induced indocyanine green fluorescence in a rat model.

Giunta, RE; Holzbach, T; Taskov, C; Holm, PS; Brill, T; Busch, R; Gansbacher, B; Biemer, E

doi:10.1016/j.bjps.2005.02.018

2005

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Title:: Prediction of flap necrosis with laser induced indocyanine green fluorescence in a rat model.
Document type:: Journal Article; Article
Author(s):: Giunta, RE; Holzbach, T; Taskov, C; Holm, PS; Brill, T; Busch, R; Gansbacher, B; Biemer, E
Abstract:: Prediction of necrosis has a clinical relevance in all fields of plastic surgery. The new application of indocyanine green (ICG) fluoroscopy in plastic surgery allows an objective quantification of skin perfusion and a high topographical resolution. The aim of the present study is to determine threshold values for flap perfusion under well-defined experimental conditions. Twenty random pattern flaps with a length to width ratio of 4:1 (8 x 2 cm(2)) were dissected on the anterior abdominal wall of 20 male Sprague-Dawley rats. ICG fluoroscopy was performed at the end of the operation. The animals were sacrificed at the seventh postoperative day with a reliable necrosis of the distal part of the flaps. Postoperative ICG fluoroscopy then was analysed both in regions that will survive and undergo necrosis. At day 7 a mean area of 5.5 cm(2) (57% of the total flap area) survived and a mean of 3.8 cm(2) (43%) became necrotic. The surviving part of the flap had a mean perfusion index of 62% compared to reference skin. The distal parts of the flap that necrotised showed an average perfusion index of only 19% postoperatively. Differences were statistically highly significant (p<0.001). Indocyanine green fluoroscopy is a useful tool to evaluate perfusion topographically and predict necrosis. From a statistical point of view a perfusion index of less than 25% of the reference skin can be considered as a sign of developing flap necrosis.
Journal title abbreviation:: Br J Plast Surg
Year:: 2005
Journal volume:: 58
Journal issue:: 5
Pages contribution:: 695-701
Language:: eng
Fulltext / DOI:: doi:10.1016/j.bjps.2005.02.018
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/15925341
Print-ISSN:: 0007-1226
TUM Institution:: Institut für Experimentelle Onkologie und Therapieforschung; Institut für Medizinische Statistik und Epidemiologie; Lehrstuhl für Plastische Chirurgie und Handchirurgie (Prof. Machens)
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