Li Ke, Zhang Zheng, Nicoli Fabio, D'Ambrosia Christopher, Xi Wenjing, Lazzeri Davide, Feng Shaoqing, Su Weijie, Li Hua, Ciudad Pedro, Tremp Mathias, Zhang Yi Xin
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Plastic and Reconstructive Surgery, University of Rome "Tor Vergata," Rome, Italy.
J Reconstr Microsurg. 2018 Feb;34(2):77-86. doi: 10.1055/s-0037-1606536. Epub 2017 Oct 9.
The vascularization of the distal portions of transferred tissue represents the most critical factor in the success of reconstructive surgery. In recent years, indocyanine green (ICG) fluorescence imaging techniques have been applied during surgery to evaluate flap perfusion. However, this investigation has found that there is little consensus regarding the standard dose of ICG as well as the pre-operative requirements of ICG allergy testing. The aim of this study is to summarize the applications of ICG to tissue transfers and safe dosing practices and to provide insight to the possible adverse effects of ICG on flap surgery with the goal of helping clinicians apply ICG safely and efficiently to tissue transfer procedures.
A literature search was performed using, Wiley InterScience, and Springer with the key words, 'Flap,' 'indocyanine green,' 'surgery,' and related mesh words for all publications between 2005 and 2015. Title and abstract screening was performed using predefined in- and exclusion criteria.
Seventy-three articles were included. These were classified as "application of ICG in flap surgery" and "the security of applying ICG in flap surgery".
ICG fluorescence imaging preoperatively facilitates the detection of perforators in tissue flaps with thickness <20 mm, aids in the evaluation of flap microcirculation and perfusion, and allows surgeons to select dominant cutaneous nerves while evaluating the quality of vascular anastomoses and locating thromboses. The literature also concluded that potential allergic reactions to ICG should be taken into consideration.
移植组织远端的血管化是重建手术成功的最关键因素。近年来，吲哚菁绿（ICG）荧光成像技术已应用于手术中以评估皮瓣灌注情况。然而，本研究发现，关于ICG的标准剂量以及术前ICG过敏试验的要求，目前尚无共识。本研究的目的是总结ICG在组织移植中的应用及安全给药方法，并深入了解ICG对皮瓣手术可能产生的不良反应，以期帮助临床医生安全、有效地将ICG应用于组织移植手术。
使用Wiley InterScience和Springer数据库进行文献检索，关键词为“皮瓣”“吲哚菁绿”“手术”及相关主题词，检索2005年至2015年间的所有出版物。使用预先设定的纳入和排除标准进行标题和摘要筛选。
共纳入73篇文章。这些文章分为“ICG在皮瓣手术中的应用”和“ICG在皮瓣手术中应用的安全性”两类。
术前ICG荧光成像有助于检测厚度<20mm的组织皮瓣中的穿支血管，辅助评估皮瓣微循环和灌注情况，并使外科医生在评估血管吻合质量和定位血栓时能够选择主要的皮神经。文献还得出结论，应考虑ICG潜在的过敏反应。
