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吲哚菁绿近红外荧光血管造影术在评估乳房切除术后皮瓣灌注中的应用

The Utility of Indocyanine Green Near-Infrared Fluoroangiographyin Assessing Mastectomy Skin Flap Perfusion.

作者信息

Azzena Gian Paolo, Brambullo Tito, Ricci Federico, Pandis Laura, Marchet Alberto, Vindigni Vincenzo, Bassetto Franco

机构信息

Plastic and Reconstructive Surgery, Neuroscience Department, University of Padua, Via Giustiniani 2, 35128 Padova, Italy.

Division of Breast Surgery, Veneto Institute of Oncology IOV-IRCCS, Via Gattamelata 64, 35128 Padova, Italy.

出版信息

J Clin Med. 2024 Nov 29;13(23):7270. doi: 10.3390/jcm13237270.

Abstract

Breast reconstruction with implants is now the preferred procedure following mastectomies. For successful reconstruction, accurate evaluation of the patient and skin flap viability is essential. This study aimed to analyze the impact of risk factors on mastectomy skin flap necrosis (MSFN) and the effectiveness of indocyanine green angiography (ICGA) in preventing complications. Fifty consecutive patients undergoing mastectomy were divided into two groups (arms A and B) based on the method of skin flap evaluation (ICGA vs. clinical assessment, respectively). Demographic details and the risk factor incidence were collected, and complication rates were compared between the two groups. Univariate analysis was conducted to identify correlations between mastectomy skin flap necrosis and the aforementioned risk factors. The two groups showed comparable demographics and incidences of risk factors. Patients in arm A exhibited a lower rate of complications and reinterventions, although no significant differences were observed. Statistical analysis revealed a significant association between BMI, implant volume, and MSFN. ICGA proves to be an effective diagnostic tool for assessing skin flap viability. When coupled with meticulous patient selection, it aids in preventing complications.

摘要

乳房切除术后采用植入物进行乳房重建现已成为首选手术方式。为实现成功重建,对患者进行准确评估以及评估皮瓣活力至关重要。本研究旨在分析风险因素对乳房切除术后皮瓣坏死(MSFN)的影响以及吲哚菁绿血管造影(ICGA)在预防并发症方面的有效性。连续50例接受乳房切除术的患者根据皮瓣评估方法(分别为ICGA与临床评估)分为两组(A组和B组)。收集人口统计学细节和风险因素发生率,并比较两组的并发症发生率。进行单因素分析以确定乳房切除术后皮瓣坏死与上述风险因素之间的相关性。两组在人口统计学和风险因素发生率方面具有可比性。A组患者的并发症和再次干预发生率较低,尽管未观察到显著差异。统计分析显示BMI、植入物体积与MSFN之间存在显著关联。ICGA被证明是评估皮瓣活力的有效诊断工具。与精心的患者选择相结合时,它有助于预防并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6316/11642667/e2e084d3054b/jcm-13-07270-g001.jpg

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