Gurtner Geoffrey C, Jones Glyn E, Neligan Peter C, Newman Martin I, Phillips Brett T, Sacks Justin M, Zenn Michael R
Plastic and Reconstructive Surgery, Duke University Medical Center, Durham, NC, USA.
Ann Surg Innov Res. 2013 Jan 7;7(1):1. doi: 10.1186/1750-1164-7-1.
Inadequate tissue perfusion is a key contributor to early complications following reconstructive procedures. Accurate and reliable intraoperative evaluation of tissue perfusion is critical to reduce complications and improve clinical outcomes. Clinical judgment is the most commonly used method for evaluating blood supply, but when used alone, is not always completely reliable. A variety of other methodologies have been evaluated, including Doppler devices, tissue oximetry, and fluorescein, among others. However, none have achieved widespread acceptance. Recently, intraoperative laser angiography using indocyanine green was introduced to reconstructive surgery. This vascular imaging technology provides real-time assessment of tissue perfusion that correlates with clinical outcomes and can be used to guide surgical decision making. Although this technology has been used for decades in other areas, surgeons may not be aware of its utility for perfusion assessment in reconstructive surgery. A group of experts with extensive experience with intraoperative laser angiography convened to identify key issues in perfusion assessment, review available methodologies, and produce initial recommendations for the use of this technology in reconstructive procedures.
组织灌注不足是重建手术后早期并发症的关键促成因素。准确可靠的术中组织灌注评估对于减少并发症和改善临床结果至关重要。临床判断是评估血供最常用的方法，但单独使用时并不总是完全可靠。已经评估了多种其他方法，包括多普勒设备、组织血氧测定法和荧光素等。然而，这些方法都没有得到广泛认可。最近，使用吲哚菁绿的术中激光血管造影术被引入重建外科。这种血管成像技术可提供与临床结果相关的组织灌注实时评估，并可用于指导手术决策。尽管这项技术在其他领域已经使用了几十年，但外科医生可能并不了解其在重建手术中进行灌注评估的效用。一组在术中激光血管造影方面有丰富经验的专家召开会议，以确定灌注评估中的关键问题，回顾可用的方法，并就该技术在重建手术中的应用提出初步建议。
