稀释吲哚青绿血管造影:重建显微外科中游离皮瓣灌注评估的新方法。

IF 1.5 Q3 SURGERY
Plastic and Reconstructive Surgery Global Open Pub Date : 2024-11-05 eCollection Date: 2024-11-01 DOI:10.1097/GOX.0000000000006280
Parintosa Atmodiwirjo, Mohamad Rachadian Ramadan, Aditya Wicaksana, Michael Djohan, Nadira Fildza Amanda, Nadhira Anindita Ralena, Ismail Hadisoebroto Dilogo, Purnomo Sidi Priambodo, Retno Asti Werdhani, Em Yunir, Lisnawati Rachmadi, Alida Roswita Harahap, Prasandhya Astagiri Yusuf, Lisa Hasibuan, Daisuke Mito
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引用次数: 0

摘要

背景:在临床实践中,评估游离皮瓣的灌注情况至关重要。吲哚菁绿(ICG)血管造影利用近红外成像监测皮瓣血管,是一种更客观、可重复的方法。本研究旨在评估稀释的 ICG 作为评估游离皮瓣灌注的工具的有效性:这项试验性随机临床试验比较了 ICG 在 3 种不同稀释度下的荧光浓度:方法:这项试验性随机临床试验比较了 3 种不同稀释度的 ICG 荧光浓度:5 毫克/毫升(标准浓度)、2.5 毫克/毫升(标准浓度的一半)和 0.5 毫克/毫升(标准浓度的十分之一)。纳入标准要求参与者的血清白蛋白水平高于 3 g/dL,血红蛋白水平高于 10 g/dL,且无合并症。根据 ICG 浓度将参与者随机分为 3 组。使用 ImageJ 软件进行荧光分析,以确定平均灰度值。外科医生和数据分析师对ICG的浓度均为盲法,以确保评估无偏见:45名接受游离皮瓣手术的患者主要为男性(60%),平均年龄为(37.76 ± 19.79)岁,平均体重指数为(21.23 ± 4.49)kg/m²,主要接受骨膜腓骨游离皮瓣(46.67%),平均皮瓣面积为(66.07 ± 46.94)cm²。主要病因是潜在肿瘤(84.4%),头颈部是最常见的重建部位(82.2%)。甲状腺上动脉是最常用的受体血管(37.78%)。分析显示平均灰度值为 64.10 ± 8.27(5 毫克/毫升)、79.03 ± 2.7(2.5 毫克/毫升)和 33.56 ± 3.47(0.5 毫克/毫升),其中 2.5 毫克/毫升的灰度值最高(P < 0.001):研究结果表明,使用 2.5 毫克/毫升的浓度可增强荧光发射,为临床实践提供了一种剂量选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diluted Indocyanine Green Angiography: A Novel Approach to Free Flap Perfusion Evaluation in Reconstructive Microsurgery.

Background: Assessing perfusion in free flaps is crucial in clinical practice. Indocyanine green (ICG) angiography offers a more objective and reproducible method, utilizing near-infrared imaging to monitor flap vascularization. This study aims to evaluate the efficacy of diluted ICG as a tool for assessing free flap perfusion.

Methods: This pilot randomized clinical trial compares the fluorescence concentrations of ICG at 3 different dilutions: 5 mg/mL (standard concentration), 2.5 mg/mL (half the standard concentration), and 0.5 mg/mL (one-tenth of the standard concentration). Inclusion criteria required participants to have serum albumin levels above 3 g/dL, hemoglobin levels over 10 g/dL, and no comorbidities. Participants were randomized into 3 groups based on ICG concentration. Fluorescence analysis was performed using ImageJ software to determine mean gray values. Both surgeons and data analysts were blinded to the ICG concentrations administered, ensuring unbiased evaluation.

Results: Forty-five patients undergoing free flap surgery, predominantly male (60%) with a mean age of 37.76 ± 19.79 years and a mean body mass index of 21.23 ± 4.49 kg/m², primarily received osteoseptocutaneous fibular free flaps (46.67%), with an average skin flap area of 66.07 ± 46.94 cm². The primary etiology was underlying tumors (84.4%), with the head and neck as the most common reconstruction site (82.2%). The superior thyroid artery was the most frequently used recipient vessel (37.78%). Analysis revealed mean gray values of 64.10 ± 8.27 (5 mg/mL), 79.03 ± 2.7 (2.5 mg/mL), and 33.56 ± 3.47 (0.5 mg/mL), with 2.5 mg/mL yielding the highest value (P < 0.001).

Conclusions: Findings suggest using 2.5 mg/mL concentration enhances fluorescence emission, offering a dosage alternative in clinical practice.

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来源期刊
CiteScore
2.20
自引率
13.30%
发文量
1584
审稿时长
10 weeks
期刊介绍: Plastic and Reconstructive Surgery—Global Open is an open access, peer reviewed, international journal focusing on global plastic and reconstructive surgery.Plastic and Reconstructive Surgery—Global Open publishes on all areas of plastic and reconstructive surgery, including basic science/experimental studies pertinent to the field and also clinical articles on such topics as: breast reconstruction, head and neck surgery, pediatric and craniofacial surgery, hand and microsurgery, wound healing, and cosmetic and aesthetic surgery. Clinical studies, experimental articles, ideas and innovations, and techniques and case reports are all welcome article types. Manuscript submission is open to all surgeons, researchers, and other health care providers world-wide who wish to communicate their research results on topics related to plastic and reconstructive surgery. Furthermore, Plastic and Reconstructive Surgery—Global Open, a complimentary journal to Plastic and Reconstructive Surgery, provides an open access venue for the publication of those research studies sponsored by private and public funding agencies that require open access publication of study results. Its mission is to disseminate high quality, peer reviewed research in plastic and reconstructive surgery to the widest possible global audience, through an open access platform. As an open access journal, Plastic and Reconstructive Surgery—Global Open offers its content for free to any viewer. Authors of articles retain their copyright to the materials published. Additionally, Plastic and Reconstructive Surgery—Global Open provides rapid review and publication of accepted papers.
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