Burnier Pierre, Niddam Jérémy, Bosc Romain, Hersant Barbara, Meningaud Jean-Paul
Department of Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.
Department of Plastic & Reconstructive Surgery, Henri Mondor Hospital, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil 94010, France.
J Plast Reconstr Aesthet Surg. 2017 Jun;70(6):814-827. doi: 10.1016/j.bjps.2017.01.020. Epub 2017 Feb 20.
Use of indocyanine green (ICG) near-infrared fluorescence as a dye to assess tissue vascularization is now well standardized. The aim of this literature review was to review and resume the most recent recommendations for ICG use in its plastic surgery applications.
A systematic literature review was performed using Medline, EMBASE, and PubMed databases to obtain the latest recommendations for ICG in plastic surgery. Inclusion criteria were all articles written in English language that evaluated pre-, intra-, or postoperative ICG applications in surgical procedures usually performed by plastic surgeons. Case reports, reviews, meta-analyses, and experimental studies on animals or cadavers were excluded after title and abstract screening.
Of the 1389 article titles retrieved, 41 full-text articles met the inclusion criteria. ICG applications in plastic surgery were ICG lymphangiography used in sentinel lymph node mapping for breast cancer and melanoma and in microsurgery for the staging and treatment of secondary chronic lymphedema. The latest updates of ICG angiography in assessing free flaps, pedicled flaps, or large skin paddles were also retrieved.
Large prospective studies suggest that ICG lymphography could be used as a single tracer to reliably perform sentinel lymph node biopsy. In the case of cutaneous melanoma, ICG lymphography increases node detection sensitivity and accuracy in conjunction with lymphoscintigraphy. In chronic lymphedema, it is useful for pre- and postoperative staging and intraoperative anatomical location of lymphatic pathways when lymphovenous bypass is indicated. ICG angiography is used intraoperatively to assess free flap anastomosis and design skin paddles and postoperatively to monitor buried flaps. In pedicled perforator flaps or for large skin paddles, intraoperative ICG angiography is strongly correlated with postoperative outcomes.
使用吲哚菁绿（ICG）近红外荧光作为染料评估组织血管化现已得到很好的规范。这篇文献综述的目的是回顾并总结ICG在整形外科应用中的最新建议。
使用Medline、EMBASE和PubMed数据库进行系统的文献综述，以获取ICG在整形外科的最新建议。纳入标准为所有用英文撰写的文章，这些文章评估了整形外科医生通常进行的手术中ICG的术前、术中和术后应用。在标题和摘要筛选后，排除病例报告、综述、荟萃分析以及动物或尸体实验研究。
在检索到的1389篇文章标题中，41篇全文文章符合纳入标准。ICG在整形外科的应用包括用于乳腺癌和黑色素瘤前哨淋巴结定位的ICG淋巴造影，以及用于继发性慢性淋巴水肿分期和治疗的显微外科手术。还检索到了ICG血管造影在评估游离皮瓣、带蒂皮瓣或大皮瓣方面的最新进展。
大型前瞻性研究表明，ICG淋巴造影可作为单一示踪剂可靠地进行前哨淋巴结活检。对于皮肤黑色素瘤，ICG淋巴造影与淋巴闪烁造影结合可提高淋巴结检测的敏感性和准确性。在慢性淋巴水肿中，当需要进行淋巴静脉旁路手术时，它有助于术前和术后分期以及术中淋巴管途径的解剖定位。ICG血管造影在术中用于评估游离皮瓣吻合和设计皮瓣，术后用于监测埋藏皮瓣。对于带蒂穿支皮瓣或大皮瓣，术中ICG血管造影与术后结果密切相关。
3级。
