Intra- and Early Postoperative Evaluation of Malperfused Areas in an Irradiated Random Pattern Skin Flap Model Using Indocyanine Green Angiography and Near-Infrared Reflectance-Based Imaging and Infrared Thermography.

imaging irradiation malperfusion

Journal

Journal of personalized medicine
ISSN: 2075-4426
Titre abrégé: J Pers Med
Pays: Switzerland
ID NLM: 101602269

Informations de publication

Date de publication:
08 Feb 2022
Historique:
received: 17 11 2021
revised: 18 01 2022
accepted: 27 01 2022
entrez: 25 2 2022
pubmed: 26 2 2022
medline: 26 2 2022
Statut: epublish

Résumé

Assessment of tissue perfusion after irradiation of random pattern flaps still remains a challenge. Twenty-five rats received harvesting of bilateral random pattern fasciocutaneous flaps. Group 1 served as nonirradiated control group. The right flaps of the groups 2-5 were irradiated with 20 Gy postoperatively (group 2), 3 × 12 Gy postoperatively (group 3), 20 Gy preoperatively (group 4) and 3 × 12 Gy preoperatively (group 5). Imaging with infrared thermography, indocyanine green angiography and near-infrared reflectance-based imaging were performed to detect necrotic areas of the flaps. Analysis of the percentage of the necrotic area of the irradiated flaps showed a statistically significant increase from day 1 to 14 only in group 5 ( Indocyanine green angiography is more precise in prediction of necrotic areas in random pattern skin flaps when compared to hyperspectral imaging, thermography or clinical impression. Preoperative fractional irradiation with a lower individual dose but a higher total dose has a more negative impact on flap perfusion compared to higher single stage irradiation.

Sections du résumé

BACKGROUND BACKGROUND
Assessment of tissue perfusion after irradiation of random pattern flaps still remains a challenge.
METHODS METHODS
Twenty-five rats received harvesting of bilateral random pattern fasciocutaneous flaps. Group 1 served as nonirradiated control group. The right flaps of the groups 2-5 were irradiated with 20 Gy postoperatively (group 2), 3 × 12 Gy postoperatively (group 3), 20 Gy preoperatively (group 4) and 3 × 12 Gy preoperatively (group 5). Imaging with infrared thermography, indocyanine green angiography and near-infrared reflectance-based imaging were performed to detect necrotic areas of the flaps.
RESULTS RESULTS
Analysis of the percentage of the necrotic area of the irradiated flaps showed a statistically significant increase from day 1 to 14 only in group 5 (
CONCLUSION CONCLUSIONS
Indocyanine green angiography is more precise in prediction of necrotic areas in random pattern skin flaps when compared to hyperspectral imaging, thermography or clinical impression. Preoperative fractional irradiation with a lower individual dose but a higher total dose has a more negative impact on flap perfusion compared to higher single stage irradiation.

Identifiants

pubmed: 35207725
pii: jpm12020237
doi: 10.3390/jpm12020237
pmc: PMC8880010
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Wibke Müller-Seubert (W)

Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg FAU, 91054 Erlangen, Germany.

Patrick Ostermaier (P)

Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg FAU, 91054 Erlangen, Germany.

Raymund E Horch (RE)

Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg FAU, 91054 Erlangen, Germany.

Luitpold Distel (L)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg FAU, 91054 Erlangen, Germany.

Benjamin Frey (B)

Translational Radiobiology, Department of Radiation Oncology, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg FAU, 91054 Erlangen, Germany.

Aijia Cai (A)

Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg FAU, 91054 Erlangen, Germany.

Andreas Arkudas (A)

Laboratory for Tissue Engineering and Regenerative Medicine, Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich Alexander University Erlangen-Nuremberg FAU, 91054 Erlangen, Germany.

Classifications MeSH