Abstract
Perforator-based flap surgery requires precise preoperative detection of suitable vascular pedicles. Indocyanine green fluorography has recently been developed to visualize subcutaneous arteries through the skin surface for this purpose. The examination is performed one or two days before the flap surgery. Patients are injected with indocyanine green intra-arterially or intravenously and fluorescence from subcutaneous arteries is recorded with an infrared video camera system. Practical pictures of a subcutaneous artery can be obtained for preoperative evaluations of the nutrient vessels of a skin flap and the blood flow within a skin flap. Compared with other imaging techniques such as CT angiography and ultrasonic Doppler flowmetry, indocyanine green angiography provides an advantage in identifying precise blood flow of subcutaneous arteries in two-dimensional visualization, which makes it possible to directly apply the information thus obtained to the planning of skin flaps.
This method is considered to be a useful preoperative clinical examination that can improve the safety and reliability of flap surgery.
