The success or failure of a reconstruction is largely related to the vascularization of the operated area. Near infrared fluorescence (also near infrared fluorescence angiography, NIR FA) with ICG administration is an innovative technique to quantify tissue perfusion. Based on the results obtained in other subspecialties, NIR fluorescence appears to be a promising way to quantify tissue perfusion in reconstructive surgery. Fluorescence research has previously been used in the context of microsurgery and breast reconstructions using implants, but structural objective determinations are lacking. Our study is successful if we are able to determine a cut off value for the absolute or relative perfusion parameters.
Study Type
OBSERVATIONAL
Enrollment
160
Administration of ICG during surgery and recording of the fluorescence video to perform data analyses
Amsterdam UMC
Amsterdam, Netherlands
Maximum perfusion intensity (Normal)
1\. Maximum perfusion intensity (Imax, units) in a normal vascularized reference frame
Time frame: Once during the surgery
Maximum perfusion intensity (ROI)
2\. Maximum perfusion intensity (Imax, units) in a normal vascularized reference frame
Time frame: Once during the surgery
Relative Perfusion
Maximum perfusion intensity (Imax, units) in a normal vascularized reference frame / Maximum perfusion intensity (Imax, units) in a normal vascularized reference frame
Time frame: Once during the surgery
Tmax
Time to reach maximum perfusion in region of interest (Tmax, sec)
Time frame: Once during the surgery
Ingress
Rate of increase in intensity from baseline to peak intensity (Ingress, units)
Time frame: Once during the surgery
Egress
Degree of decrease in intensity from peak to last measurement (Egress, units)
Time frame: Once during the surgery
Lap Failure
Quantified as I \<5%; II 5-15%, III 15-50%, IV\> 50%, V complete
Time frame: Follow up at six weeks postoperative
Wound infection
Defined as none, local wound treatment, antibiotics, or hospitalization.
Time frame: Follow up at six weeks postoperative
Skin necrosis
Defined as none, partial thickness, and full thickness.
Time frame: Follow up at six weeks postoperative
Delayed union
Radiologic examination (Xray or CT) concluding on the presence of delayed union after 6 months or non-union after 12 months
Time frame: Follow up at six and twelve months postoperative
Relative Perfusion before and after tissue transfer
Maximum perfusion intensity (Imax, units) in the same reference frame after tissue transfer / Maximum perfusion intensity (Imax, units) in a reference frame before tissue transfer
Time frame: Twice during the surgery
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