Face transplant perfusion assessment using near-infrared fluorescence imaging.

The Journal of Surgical Research
John T NguyenBernard T Lee

Abstract

Composite tissue allografts (CTAs) including partial face transplantation have been achieved clinically. However, risks of complications including tissue ischemia, rejection, and transplant failure are significant. Safe and effective techniques to assess perfusion are needed to decrease complications in composite tissue flaps. Near-infrared (NIR) fluorescence imaging has been previously shown to provide a real-time, intraoperative evaluation of perfusion. This study investigates the use of NIR imaging in partial face CTA harvest. We created hemifacial CTAs (n = 8) using an established porcine model. This included ear cartilage, nerve, lymphoid tissue, muscle, and skin with perfusion by the carotid artery and external jugular vein. We injected animals systemically with indocyanine green and obtained NIR fluorescence images simultaneously with color video. In addition, we assessed the elevated hemifacial flaps using standard of care (i.e., clinical examination and Doppler). Flap design was facilitated by NIR imaging with localization of perforators to the hemifacial CTA flap. In particular, an arterial and venous phase could be clearly identified. We assessed perfusion of the flap by NIR fluorescence intensity after injection of ...Continue Reading

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Citations

May 28, 2013·The Journal of Surgical Research·John T NguyenBernard T Lee
Dec 20, 2015·Current Problems in Surgery·Dan E AzaguryBrendan C Visser
May 22, 2018·European Journal of Plastic Surgery·Anouk J M CornelissenRutger M Schols
Jan 17, 2019·Annals of Surgery·Erika M WalshJason M Warram
Jan 29, 2016·Plastic and Reconstructive Surgery·Brett T PhillipsMichael R Zenn

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