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

IF 1.2 4区医学 Q3 SURGERY

Surgical Innovation Pub Date : 2024-12-01 Epub Date: 2024-08-07 DOI:10.1177/15533506241273383

Manuela Mastronardi, Stefano Fracon, Serena Scomersi, Margherita Fezzi, Zaira Pellin, Marina Bortul

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引用次数: 0

Abstract

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.

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定性和定量吲哚菁绿血管造影在评估乳房切除术皮瓣灌注中的作用：前瞻性单中心经验。

导言：乳房切除皮瓣（MSF）坏死仍然是乳房重建中的一个重要并发症。本研究旨在利用吲哚菁绿血管造影术（ICGA）确定术后 1 个月 MSF 灌注等级的定性和定量分析与皮肤坏死率之间的相关性，重点关注滞后时间和灌注指标：在 2020 年 5 月至 2022 年 10 月期间计划进行乳头/皮肤间隔/皮肤缩小乳房切除术的连续女性患者均被纳入前瞻性研究。患者被分为没有表皮和全厚坏死（SN；FTN）的第一组和同时存在表皮和全厚坏死的第二组。研究人员收集了患者的人口统计学数据、滞后时间T1（ICG注射与灌注最少的MSF区域的初始灌注之间的时间）、ICG-Q1和ICG-Q%（血管最少区域的绝对和相对灌注值）：共研究了 76 个乳房。8个乳房（10.5%）报告了FTN，4个乳房（5.2%）报告了SN。两组在 T1（第 2 组 > 第 1 组）、ICG-Q1 和 ICG-Q% （第 1 组 > 第 2 组）方面存在统计学差异（P < 0.05）。T1超过170秒、体重指数、既往化疗/放疗、动脉高血压、乳房重量、手术类型和ICG定量值有助于预测MSF坏死：MSF定性和定量灌注评估有助于预防MSF坏死。结论：MSF定性和定量灌注评估有助于预防MSF坏死，但应与患者特征、手术类型和T1一起考虑。通过这种方法，可以预测 MSF 坏死的风险，并规划最佳的重建策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Innovation 医学-外科

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).