Prediction of Skin Necrosis after Mastectomy for Breast Cancer Using Indocyanine Green Angiography Imaging

Plastic and Reconstructive Surgery. Global Open
Katsuya GoraiMasahiro Nakagawa

Abstract

In immediate tissue expander reconstruction following total mastectomy for breast cancer, indocyanine green angiography (ICGA)-guided skin trimming is useful for the prevention of complications. However, instances of unclear ICGA contrast can occur with this method, which are difficult to judge as to whether preventive trimming is warranted. To further improve the mastectomy flap necrosis rate, more accurate objective parameters are necessary. The degree of clinical improvement was compared between 81 patients trimmed according to the surgeon's judgment (non-ICGA group) and 100 patients with ICGA-guided trimming (ICGA group). We then retrospectively measured 3 parameters [relative perfusion (RP); time (T) to reach RPmax; and slope (S = RP/T) reflecting the rate of increase to RPmax] by using region of interest analysis software and examined their relationships with skin necrosis. The rate of grade III necrosis (reaching the subcutaneous fat layer) was significantly lower in the ICGA group (4.8%) than in the non-ICGA group (17.8%; P < 0.05). The specificity of RP for the diagnosis of skin necrosis was high (98.5%; cutoff value, 34). However, the sensitivities of slope parameters were higher than RP. ICGA-guided trimming decrease...Continue Reading

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Citations

Mar 7, 2018·Archives of Plastic Surgery·Ralph VerstappenThomas Bauer
Aug 15, 2018·Aesthetic Surgery Journal·Berry FairchildMark W Clemens
Jul 12, 2018·Annals of Surgery·Robert J DabekDaniel Driscoll
Oct 26, 2018·Aesthetic Surgery Journal·Paloma Malagón-LópezCarmen Higueras-Suñe
Oct 19, 2019·Plastic and Reconstructive Surgery. Global Open·Mikaela L KislevitzBardia Amirlak
Nov 28, 2019·Journal of Surgical Oncology·Edgard da Silva NetoRenato A Prates
Sep 6, 2018·Breast Cancer Research and Treatment·Walter P WeberMichael Gnant
Jun 17, 2020·Plastic and Reconstructive Surgery. Global Open·Ariel C JohnsonDavid W Mathes
Sep 19, 2018·Annals of Surgical Oncology·Viviana GalimbertiPaolo Veronesi
Jun 17, 2020·Plastic and Reconstructive Surgery. Global Open·Gaik Si QuahElisabeth Elder
Dec 15, 2020·The Breast : Official Journal of the European Society of Mastology·Dong-Yun KimIn Ah Kim
May 2, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Elisabeth Lauritzen, Tine Engberg Damsgaard

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