Intraoperative fluorescence angiography: a review of applications and outcomes in war-related trauma

Military Medicine
J Marshall GreenIan L Valerio

Abstract

In the recent Iraq and Afghanistan conflicts, survival rates from complex battlefield injuries have continued to improve. The resulting war-related wounds are challenging, with confounding issues making assessment of tissue perfusion subjective and variable. This review discusses the utility of intraoperative fluorescence angiography, and its usefulness as an objective tool to evaluate the perfusion of tissues in the face of complex war-related injuries. A retrospective review of all war-related traumatic and reconstructive cases employing intraoperative indocyanine green laser angiography (ICGLA) was performed. Data analyzed included indication for use, procedure success/failure rates, modifications performed, and perfusion-related complications. Anatomical regions assessed were extremity, head and neck, truncal, and intra-abdominal viscera. The endpoint of specific interest involved the decision for additional debridement of poorly perfused tissue, as based on the ICGLA findings. Over a 3-year period, this study examined 123 extremity soft tissue flaps, 41 extremity injuries including amputation and/or amputation revision cases, 13 craniofacial flaps, and 9 truncal/abdomen/gastrointestinal cases in which ICGLA was utilized to...Continue Reading

Citations

Apr 5, 2016·Military Medical Research·Margaret ConnollyOwen N Johnson
Sep 7, 2017·Current Opinion in Otolaryngology & Head and Neck Surgery·Elisa IllingCecelia E Schmalbach
Mar 10, 2020·Annals of Plastic Surgery·Jacob B HammondAlanna M Rebecca
Jul 23, 2020·Surgical Endoscopy·Christian D LütkenNikolaj Nerup
May 1, 2018·Plastic and Reconstructive Surgery. Global Open·Elbert E VacaEduardo D Rodriguez
Apr 19, 2016·Journal of Biomedical Optics·Michael G SowaDavid G Armstrong
Nov 19, 2020·Military Medicine·Justin P FoxKerry P Latham
Dec 11, 2020·Plastic and Reconstructive Surgery. Global Open·Christine VelazquezIvo A Pestana

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