Laser-assisted-indocyanine-green-angiography versus conventional assessment to predict or locate necrotic areas on mastectomy flaps: A prospective clinical trial
Objective: The aim of this study was to determine whether laser- assisted-indocyanine-green-angiography (LA-ICGA) could accurately predict flap necrosis in comparison to conventional clinical assessment and visually identify its location during immediate reconstruction following a nipple-sparing mas...
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Published in | İstanbul Tıp Fakültesi Dergisi Vol. 82; no. 4; pp. 193 - 198 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
İstanbul Üniversitesi Yayınları
01.10.2019
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Subjects | |
Online Access | Get full text |
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Summary: | Objective: The aim of this study was to determine whether laser-
assisted-indocyanine-green-angiography (LA-ICGA) could accurately
predict flap necrosis in comparison to conventional clinical
assessment and visually identify its location during immediate
reconstruction following a nipple-sparing mastectomy (NSM).
Methods: Twenty-one patients with breast cancer were prospectively
enrolled to undergo NSM with immediate implant reconstruction.
In 19 cases LA-ICGA numbers were used to show the
level of laser absorption of hypo-perfused areas on the mastectomy
flaps. Those numbers were compared to conventional assessment
to assess the predictive value of LA-ICGA.
Results: Of the 19 mastectomy flaps, 3 (15.8%) examples of partial
skin flap necrosis with an LA-ICGA value of ≤7 was observed. The
sensitivity, specificity, false-positive rate, and accuracy of LA-ICGA
were 43%, 100%, 57%, and 79%, respectively. Patients with an
LA-ICGA value of ≤7 were found more likely to develop mastectomy
flap necrosis, whereas patients aged >60 or, a history of smoking,
a BMI >30, or intraoperative use of tumescence solution containing
epinephrine were more likely to have an LA-ICGA score ≤7
which is not clinically reliable in predicting necrosis.
Conclusion: Our results indicate that a low LA-ICGA score ≤7
is the only significant factor in predicting mastectomy flap necrosis.
LA-ICGA could accurately show the location of necrosis. |
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ISSN: | 1305-6441 |
DOI: | 10.26650/IUITFD.2019.0040 |