Role of Qualitative and Quantitative Indocyanine Green Angiography to Assess Mastectomy Skin Flaps Perfusion: A Prospective Monocentric Experience.

Autor:	Mastronardi M; Division of General Surgery, Department of Medical and Surgical Sciences, Cattinara University Hospital, Trieste, Italy., Fracon S; Division of General Surgery, Department of Medical and Surgical Sciences, Cattinara University Hospital, Trieste, Italy.; Breast Cancer Surgery Unit, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy., Scomersi S; Division of General Surgery, Department of Medical and Surgical Sciences, Cattinara University Hospital, Trieste, Italy.; Breast Unit, Cattinara University Hospital, Trieste, Italy., Fezzi M; Division of General Surgery, Department of Medical and Surgical Sciences, Cattinara University Hospital, Trieste, Italy.; Breast Unit, Cattinara University Hospital, Trieste, Italy., Pellin Z; Division of General Surgery, Department of Medical and Surgical Sciences, Cattinara University Hospital, Trieste, Italy., Bortul M; Division of General Surgery, Department of Medical and Surgical Sciences, Cattinara University Hospital, Trieste, Italy.; Breast Unit, Cattinara University Hospital, Trieste, Italy.
Jazyk:	angličtina
Zdroj:	Surgical innovation [Surg Innov] 2024 Dec; Vol. 31 (6), pp. 605-617. Date of Electronic Publication: 2024 Aug 07.
DOI:	10.1177/15533506241273383
Abstrakt:	Introduction: Mastectomy skin flap (MSF) necrosis remains a significant complication in breast reconstruction. This study aims to identify a correlation between the qualitative and quantitative analysis of the MSF perfusion grade and the skin necrosis rate 1 month after surgery using indocyanine green angiography (ICGA), focusing on lag time and perfusion metrics. Methods: Consecutive women scheduled for nipple/skin-sparing/skin-reducing mastectomy between May 2020 and October 2022 were prospectively enrolled. Patients were divided into Group 1 in the absence of superficial and full-thickness necrosis (SN; FTN) and Group 2 in the presence of both. Demographic data, lag time T1 (time between ICG injection and the initial perfusion of the least perfused MSF area), ICG-Q1, and ICG-Q% (absolute and relative perfusion values of the least vascularized area) were collected. Results: 76 breasts were considered. FTN was reported in 8 breasts (10.5%) and SN in 4 (5.2%). The 2 groups statistically differ in T1 (Group2 > Group1), ICG-Q1, and ICG-Q% (Group1 > Group2) ( P < 0.05). T1 longer than 170 seconds, body mass index, previous chemo/radiotherapy, arterial hypertension, breast weight, type of surgery, and ICG quantitative values can help in predicting MSF necrosis. Conclusions: MSF qualitative and quantitative perfusion evaluation can be helpful to prevent MSF necrosis. However, it should be considered together with the patient's characteristics, the type of surgery, and T1. In this way, it is possible to predict the risk of MSF necrosis and plan the best reconstructive strategy. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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