S. Eren et al., ASSESSMENT OF MICROCIRCULATION OF AN AXIAL SKIN FLAP USING INDOCYANINE GREEN FLUORESCENCE ANGIOGRAPHY, Plastic and reconstructive surgery, 96(7), 1995, pp. 1636-1649
In many cases the complexities of skin-flap microcirculation are diffi
cult to assess despite all the subjective and objective examination te
chniques available today. Adequate microcirculation is essential for t
issue viability, so any method employed for studying microcirculation
should provide as accurate an assessment of the prevailing conditions
as possible. Of all the clinical methods, the fluorescence technique u
sing the dye sodium fluorescein has so far provided the most reliable
results. However, the pharmacokinetic properties of this tracer have p
revented the technique from becoming established in clinical practice.
The fluorescent dye indocyanine green (Cardio Green), on the other ha
nd, has far more favorable pharmacokinetics. In an experimental animal
model, the fluorescence technique using indocyanine green (indocyanin
e green angiography, ICGA) was used to study postoperative changes in
the microcirculation of a skin flap. On the day of operation, indocyan
ine green angiography revealed a state of hemodynamic imbalance for wh
ich the organism was able to compensate in the postoperative phase wit
h the aid of humoral, physical, and metabolic factors. With indocyanin
e green angiography it was possible to quantify objectively the new he
modynamic equilibrium. Basically, microcirculation may be quantified i
n temporal and spatial terms. The significant objectivity of indocyani
ne green angiography and short intervals between each examination favo
r its possible and meaningful use in clinical practice and give cause
for continuing studies.