Prediction of Mastectomy Skin Flap Necrosis With Indocyanine Green Angiography and Thermography: A Retrospective Comparative Study.

Autor: Pagliara D; Plastic-Reconstructive and Lymphedema Microsurgery Center, Mater Olbia Hospital, Olbia, Italy. Electronic address: domenicopag@gmail.com., Serra PL; Department of Medical, Surgical and Experimental Sciences, Plastic Surgery Unit, University of Sassari, Sassari University Hospital Trust, Sassari, Italy., Pili N; Department of Medical, Surgical and Experimental Sciences, Plastic Surgery Unit, University of Sassari, Sassari University Hospital Trust, Sassari, Italy., Giardino FR; Plastic-Reconstructive and Lymphedema Microsurgery Center, Mater Olbia Hospital, Olbia, Italy., Grieco F; Department of Medical, Surgical and Experimental Sciences, Plastic Surgery Unit, University of Sassari, Sassari University Hospital Trust, Sassari, Italy., Schiavone L; Department of Surgery 'P.Valdoni', Unit of Plastic and Reconstructive Surgery, Sapienza University of Rome, Roma, Italy., Lattanzi M; Division of Plastic Surgery, Policlinico of Modena, University of Modena and Reggio Emilia, Modena, Italy., Rubino C; Department of Medical, Surgical and Experimental Sciences, Plastic Surgery Unit, University of Sassari, Sassari University Hospital Trust, Sassari, Italy., Ribuffo D; Department of Surgery 'P.Valdoni', Unit of Plastic and Reconstructive Surgery, Sapienza University of Rome, Roma, Italy., De Santis G; Division of Plastic Surgery, Policlinico of Modena, University of Modena and Reggio Emilia, Modena, Italy., Salgarello M; Department of Woman and Child Health and Public Health, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy., Nahabedian MY; National Center for Plastic Surgery, McLean, Virginia, USA., Rancati A; Hospital de Clinicas Jose de San Martin School of Medicine. Universidad de Buenos Aires, Argentina.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2024 Dec; Vol. 24 (8), pp. 755-762. Date of Electronic Publication: 2024 Sep 04.
DOI: 10.1016/j.clbc.2024.08.024
Abstrakt: Objective: This study investigates the predictive role of indocyanine green angiography and thermography in assessing mastectomy skin flap necrosis in the intraoperative and postoperative setting.
Methods: A retrospective review of 45 patients who underwent nipple-sparing mastectomy and immediate prepectoral reconstruction was performed. Mastectomy flap viability was evaluated intraoperatively with indocyanine green angiography and thermography after placement of an implant sizer and again postoperatively at 24 hours. Fluorescence pattern was analyzed with a near-infrared camera (IC-Flow TM Imaging System, Diagnostic Green GmbH, Germania) and thermographic images with FLIR ONE device. FLIR ONE and ICG images were then transposed on macroscopic breast images with a scale 1:1. The mastectomy skin flap was evaluated using the SKIN score (Mayo Clinic Classification).
Results: Overlap between angiography and thermography images was 87.95% intraoperatively and 95.95% 24 hours postoperatively. Overlay with mastectomy flap necrosis was higher in the intraoperative angiography group with statistical significance. Contrarily, such a difference was not apparent in the postoperative period.
Conclusions: ICG appears to be a superior tool when used intraoperatively with fundamental implications on reconstructive decision-making, while thermography could be a valuable assessment method in the postoperative setting. Further studies are necessary to confirm such results and determine their clinical applicability.
Competing Interests: Disclosure The authors declared no potential conflicts of interest with respect to the research, authorship, and publication of this article.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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