Fluorescence angiography-assisted debridement of critically perfused glabrous skin in degloving foot injuries: Two case reports.
Adult
Aftercare
Child
Debridement
/ methods
Degloving Injuries
/ surgery
Female
Fluorescein Angiography
/ methods
Foot
/ blood supply
Foot Injuries
/ complications
Fractures, Multiple
/ surgery
Humans
Indocyanine Green
/ administration & dosage
Male
Plastic Surgery Procedures
/ methods
Skin Transplantation
/ methods
Soft Tissue Injuries
/ surgery
Surgical Flaps
/ surgery
Treatment Outcome
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
04 Jun 2021
04 Jun 2021
Historique:
received:
23
03
2021
accepted:
19
05
2021
entrez:
4
6
2021
pubmed:
5
6
2021
medline:
12
6
2021
Statut:
ppublish
Résumé
Degloving foot injuries are challenging to treat and associated with life-long sequelae for patients. An appropriate debridement of ischemic soft tissues with maximal preservation of glabrous skin is key during the reconstruction of these injuries. Indocyanine green (ICG) fluorescence angiography is an established technique for the intraoperative evaluation of tissue perfusion. Two patients sustained complex foot injuries in traffic accidents, including multiple fracture dislocations and extensive degloving of the plantar skin. Clinical inspection revealed significant degloving of the glabrous skin in both patients. After fracture fixation, ICG fluorescence angiography-assisted debridement with immediate latissimus dorsi free flap reconstruction was performed. In both cases, this technique allowed a precise debridement with maximal preservation of the glabrous skin. The healing of the remaining glabrous skin was uneventful and the 6-month follow-up was characterized by stable soft tissues and satisfying ambulation. ICG fluorescence angiography is a safe, user-friendly, and quick procedure with minimal risks, expanding the armamentarium of the reconstructive surgeon. It is highly useful for the debridement of extensive plantar degloving injuries and may also help to minimize the number of procedures and the risk of infection.
Identifiants
pubmed: 34087908
doi: 10.1097/MD.0000000000026235
pii: 00005792-202106040-00091
pmc: PMC8183782
doi:
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e26235Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no funding and conflicts of interest to disclose.
Références
Arnez ZM, Khan U, Tyler MP. Classification of soft-tissue degloving in limb trauma. J Plast Reconstr Aesthet Surg 2010;63:1865–9.
Sakai G, Suzuki T, Hishikawa T, Shirai Y, Kurozumi T, Shindo M. Primary reattachment of avulsed skin flaps with negative pressure wound therapy in degloving injuries of the lower extremity. Injury 2017;48:137–41.
Keagy RD, Head JR Jr, Kroft AE. Severe avulsion injury of the lower extremity skin. JAMA 1968;206:1567–8.
Liu DX, Li XD, Wang H, Qiu KF, Du SX. Reconstruction of total degloving injuries of the foot in children. J Trauma Acute Care Surg 2012;73:209–14.
Crowe CS, Cho DY, Kneib CJ, Morrison SD, Friedrich JB, Keys KA. Strategies for reconstruction of the plantar surface of the foot: a systematic review of the literature. Plast Reconstr Surg 2019;143:1223–44.
Rinkinen JR, Diamond S, Lans J, Cetrulo CL, Eberlin KR. Neurotized free tissue transfer for foot reconstruction: a systematic review. J Reconstr Microsurg 2020;36:32–40.
Li K, Zhang Z, Nicoli F, et al. Application of indocyanine green in flap surgery: a systematic review. J Reconstr Microsurg 2018;34:77–86.
Kamolz LP, Andel H, Auer T, Meissl G, Frey M. Evaluation of skin perfusion by use of indocyanine green video angiography: rational design and planning of trauma surgery. J Trauma 2006;61:635–41.
Yoneya S, Saito T, Komatsu Y, Koyama I, Takahashi K, Duvoll-Young J. Binding properties of indocyanine green in human blood. Invest Ophthalmol Vis Sci 1998;39:1286–90.
Liu DZ, Mathes DW, Zenn MR, Neligan PC. The application of indocyanine green fluorescence angiography in plastic surgery. J Reconstr Microsurg 2011;27:355–64.
Holm C, Tegeler J, Mayr M, Becker A, Pfeiffer UJ, Mühlbauer W. Monitoring free flaps using laser-induced fluorescence of indocyanine green: a preliminary experience. Microsurgery 2002;22:278–87.
Fox IJ, Wood EH. Applications of dilution curves recorded from the right side of the heart or venous circulation with the aid of a new indicator dye. Proc Staff Meet Mayo Clin 1957;32:541–50.
Mandell MS, Wachs M, Niemann CU, Henthorn TK. Elimination of indocyanine green in the perioperative evaluation of donor liver function. Anesth Analg 2002;95:1182–4. table of contents.
Phillips BT, Lanier ST, Conkling N, et al. Intraoperative perfusion techniques can accurately predict mastectomy skin flap necrosis in breast reconstruction: results of a prospective trial. Plast Reconstr Surg 2012;129:778e–88e.
Khavanin N, Qiu C, Darrach H, et al. Intraoperative perfusion assessment in mastectomy skin flaps: how close are we to preventing complications? J Reconstr Microsurg 2019;35:471–8.
Wongkietkachorn A, Surakunprapha P, Winaikosol K, et al. Indocyanine green dye angiography as an adjunct to assess indeterminate burn wounds: a prospective, multicentered, triple-blinded study. J Trauma Acute Care Surg 2019;86:823–8.
Brebant V, Heine N, Lamby P, et al. Augmented reality of indocyanine green fluorescence in simplified lymphovenous anastomosis in lymphatic surgery. Clin Hemorheol Microcirc 2019;73:125–33.
Rebecca AM, Mahabir RC, Pflibsen L, Hillberg N, Jensen C, Casey WJ. Indocyanine green lymphangiography as an adjunct for the optimal identification and management of lymphatic leaks in the groin. J Reconstr Microsurg 2019;35:83–9.
Uyulmaz S, Puippe G, Büyükakyüz N, Giovanoli P, Pfammatter T, Lindenblatt N. Sclerotherapy with OK-432 for the treatment of symptomatic lymphocele after lymph node dissection: a retrospective comparative cohort study. Ann Plast Surg 2020;85:407–12.
Green JM 3rd, Sabino J, Fleming M, Valerio I. Intraoperative fluorescence angiography: a review of applications and outcomes in war-related trauma. Mil Med 2015;180:37–43.
Koshimune S, Shinaoka A, Ota T, Onoda S, Kimata Y. Laser-assisted indocyanine green angiography aids in the reconstruction of Gustilo grade IIIB open lower-limb fractures. J Reconstr Microsurg 2017;33:143–50.
Pruimboom T, Schols RM, Qiu SS, van der Hulst RRWJ. Potential of near-infrared fluorescence image-guided debridement in trauma surgery. Case Reports Plast Surg Hand Surg 2018;5:41–4.
Kim M, Lee S, Park JC, et al. Anaphylactic shock after indocyanine green video angiography during cerebrovascular surgery. World Neurosurg 2020;133:74–9.
Gitajn IL, Slobogean GP, Henderson ER, et al. Perspective on optical imaging for functional assessment in musculoskeletal extremity trauma surgery. J Biomed Opt 2020;25.