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Understanding healing complications in implant-based breast reconstruction using novel metrics for indocyanine green angiography.
- Source :
-
Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2024 Oct; Vol. 97, pp. 302-309. Date of Electronic Publication: 2024 Aug 22. - Publication Year :
- 2024
-
Abstract
- Introduction: Indocyanine green (ICG) angiography for the intraoperative evaluation of tissue perfusion is commonly used in implant-based breast reconstruction (IBR). The assessment of ICG images depends on the surgeon's interpretation and is qualitative or semiqualitative in nature. To quantify ICG metrics, this study aimed to apply a novel assessment of fill-rate dynamics to predict wound-healing complications and provide pragmatic assessment tools in IBR.<br />Methods: This was a retrospective cohort study of patients who underwent IBR with ICG using the photodynamic eye (PDE-Neo II) qualitative imaging system between April 2021 and September 2023. ICG recordings were reviewed to quantify the relative surface area and fluorescence intensity of visual perfusion deficits using ImageJ. The primary outcome was the incidence of wound-healing complications. t-tests and logistic regression were performed for statistical testing.<br />Results: A total of 112 patients (201 breasts) were included. The incidence of wound-healing complications was 12.9%. A higher relative surface area of ischemic regions was significantly associated with wound-healing complications (3.3% vs. 0.90%; p = 0.001). The rate of change in the surface area of ischemic regions was significantly associated with wound-healing complications (0.35% per second vs. 1.29% per second; p = 0.003%). On average, the duration of transient ischemic areas was significantly longer in breasts with wound-healing complications (46.0 s vs. 36.0 s, p = 0.01).<br />Conclusion: A transient ischemic area of > 5% of the breast and/or failure to resolve transient ischemic areas after 60 s may predict wound-healing complications and inform surgical reconstructive decision-making in IBR.<br /> (Published by Elsevier Ltd.)
- Subjects :
- Humans
Female
Retrospective Studies
Middle Aged
Coloring Agents administration & dosage
Adult
Breast Implantation methods
Breast Implantation adverse effects
Angiography methods
Breast Neoplasms surgery
Mammaplasty methods
Mammaplasty adverse effects
Breast Implants adverse effects
Fluorescein Angiography methods
Indocyanine Green
Postoperative Complications etiology
Postoperative Complications diagnosis
Wound Healing physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1878-0539
- Volume :
- 97
- Database :
- MEDLINE
- Journal :
- Journal of plastic, reconstructive & aesthetic surgery : JPRAS
- Publication Type :
- Academic Journal
- Accession number :
- 39213931
- Full Text :
- https://doi.org/10.1016/j.bjps.2024.08.062