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Improved technique for evaluating oral free flaps by pinprick testing assisted by indocyanine green near-infrared fluorescence angiography.
J Craniomaxillofac Surg 2014; 42(7):1112-6JC

Abstract

In head and neck surgery, free-flap reconstruction using a microvascular anastomosis is an indispensable option after tumor ablation. Because the success of free-flap reconstruction is enhanced by rapid identification and salvage of failing flaps, postoperative monitoring of free flaps is essential. We describe a new technique using indocyanine green (ICG) near-infrared angiography and pinprick testing to monitor intraoral free flaps. A solution of ICG (Diagnogreen, 5 ml) was intravenously injected, and scanning was performed with a near-infrared video camera system. Thirty seconds after ICG injection, a pinprick test was performed by placing a 24-gage needle through the dermis to the subcutaneous fat of the flap. Pinprick testing during ICG fluorescence imaging was performed in 30 patients. Flap perfusion was confirmed in all patients, and all flaps survived postoperatively. ICG fluorescence imaging demonstrated that flap perfusion was maintained.

Authors+Show Affiliations

Department of Oral and Maxillofacial Surgery (Chief: Prof. Fuminori Katou), Hamamatsu University School of Medicine, 1-20-1 Handa-yama, Higashi-ku, Hamamatsu City, Shizuoka 431-3125, Japan. Electronic address: nagatez@hama-med.ac.jp.Department of Oral and Maxillofacial Surgery (Chief: Prof. Fuminori Katou), Hamamatsu University School of Medicine, 1-20-1 Handa-yama, Higashi-ku, Hamamatsu City, Shizuoka 431-3125, Japan.Department of Oral and Maxillofacial Surgery (Chief: Prof. Fuminori Katou), Hamamatsu University School of Medicine, 1-20-1 Handa-yama, Higashi-ku, Hamamatsu City, Shizuoka 431-3125, Japan.Department of Oral and Maxillofacial Surgery (Chief: Prof. Fuminori Katou), Hamamatsu University School of Medicine, 1-20-1 Handa-yama, Higashi-ku, Hamamatsu City, Shizuoka 431-3125, Japan.Department of Plastic Surgery, National Defense Medical College, Tokorozawa, Japan.Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, Tokorozawa, Japan.Department of Oral and Maxillofacial Surgery (Chief: Prof. Fuminori Katou), Hamamatsu University School of Medicine, 1-20-1 Handa-yama, Higashi-ku, Hamamatsu City, Shizuoka 431-3125, Japan.

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24530073

Citation

Nagata, Tetsuji, et al. "Improved Technique for Evaluating Oral Free Flaps By Pinprick Testing Assisted By Indocyanine Green Near-infrared Fluorescence Angiography." Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery, vol. 42, no. 7, 2014, pp. 1112-6.
Nagata T, Masumoto K, Uchiyama Y, et al. Improved technique for evaluating oral free flaps by pinprick testing assisted by indocyanine green near-infrared fluorescence angiography. J Craniomaxillofac Surg. 2014;42(7):1112-6.
Nagata, T., Masumoto, K., Uchiyama, Y., Watanabe, Y., Azuma, R., Morimoto, Y., & Katou, F. (2014). Improved technique for evaluating oral free flaps by pinprick testing assisted by indocyanine green near-infrared fluorescence angiography. Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery, 42(7), pp. 1112-6. doi:10.1016/j.jcms.2014.01.040.
Nagata T, et al. Improved Technique for Evaluating Oral Free Flaps By Pinprick Testing Assisted By Indocyanine Green Near-infrared Fluorescence Angiography. J Craniomaxillofac Surg. 2014;42(7):1112-6. PubMed PMID: 24530073.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improved technique for evaluating oral free flaps by pinprick testing assisted by indocyanine green near-infrared fluorescence angiography. AU - Nagata,Tetsuji, AU - Masumoto,Kazuma, AU - Uchiyama,Yoshiyuki, AU - Watanabe,Yoshiko, AU - Azuma,Ryuichi, AU - Morimoto,Yuji, AU - Katou,Fuminori, Y1 - 2014/01/17/ PY - 2013/05/23/received PY - 2013/11/19/revised PY - 2014/01/08/accepted PY - 2014/2/18/entrez PY - 2014/2/18/pubmed PY - 2016/2/3/medline KW - Free-tissue transfer KW - Indocyanine green KW - Microsurgery KW - Monitoring technique KW - Near-infrared angiography SP - 1112 EP - 6 JF - Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery JO - J Craniomaxillofac Surg VL - 42 IS - 7 N2 - In head and neck surgery, free-flap reconstruction using a microvascular anastomosis is an indispensable option after tumor ablation. Because the success of free-flap reconstruction is enhanced by rapid identification and salvage of failing flaps, postoperative monitoring of free flaps is essential. We describe a new technique using indocyanine green (ICG) near-infrared angiography and pinprick testing to monitor intraoral free flaps. A solution of ICG (Diagnogreen, 5 ml) was intravenously injected, and scanning was performed with a near-infrared video camera system. Thirty seconds after ICG injection, a pinprick test was performed by placing a 24-gage needle through the dermis to the subcutaneous fat of the flap. Pinprick testing during ICG fluorescence imaging was performed in 30 patients. Flap perfusion was confirmed in all patients, and all flaps survived postoperatively. ICG fluorescence imaging demonstrated that flap perfusion was maintained. SN - 1878-4119 UR - https://www.unboundmedicine.com/medline/citation/24530073/Improved_technique_for_evaluating_oral_free_flaps_by_pinprick_testing_assisted_by_indocyanine_green_near_infrared_fluorescence_angiography_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1010-5182(14)00042-0 DB - PRIME DP - Unbound Medicine ER -