Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Medicine (Baltimore). 2021 Jun 4;100(22):e26235. doi: 10.1097/MD.0000000000026235.
Degloving foot injuries are challenging to treat and associated with life-long sequelae for patients. An appropriate debridement of ischemic soft tissues with maximal preservation of glabrous skin is key during the reconstruction of these injuries. Indocyanine green (ICG) fluorescence angiography is an established technique for the intraoperative evaluation of tissue perfusion.
Two patients sustained complex foot injuries in traffic accidents, including multiple fracture dislocations and extensive degloving of the plantar skin.
Clinical inspection revealed significant degloving of the glabrous skin in both patients.
After fracture fixation, ICG fluorescence angiography-assisted debridement with immediate latissimus dorsi free flap reconstruction was performed.
In both cases, this technique allowed a precise debridement with maximal preservation of the glabrous skin. The healing of the remaining glabrous skin was uneventful and the 6-month follow-up was characterized by stable soft tissues and satisfying ambulation.
ICG fluorescence angiography is a safe, user-friendly, and quick procedure with minimal risks, expanding the armamentarium of the reconstructive surgeon. It is highly useful for the debridement of extensive plantar degloving injuries and may also help to minimize the number of procedures and the risk of infection.
脱套伤的治疗具有挑战性，会给患者带来终身后遗症。在这些损伤的重建过程中，适当的缺血性软组织清创术并最大限度地保留无毛皮肤是关键。吲哚菁绿（ICG）荧光血管造影术是一种用于评估组织灌注的术中评估技术。
两名患者在交通事故中遭受复杂的足部损伤，包括多处骨折脱位和广泛的足底皮肤脱套。
临床检查显示两名患者的无毛皮肤均有明显的脱套。
骨折固定后，行 ICG 荧光血管造影辅助清创术，并立即进行背阔肌游离皮瓣重建。
在这两种情况下，该技术均允许精确清创，并最大限度地保留了无毛皮肤。剩余无毛皮肤的愈合情况良好，6 个月随访时表现为稳定的软组织和满意的步行功能。
ICG 荧光血管造影术是一种安全、用户友好、快速的手术，风险极小，为重建外科医生提供了更多的选择。它对于广泛的足底脱套伤的清创非常有用，也有助于减少手术次数和感染风险。
