Cargando…

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

Background: Assessment of tissue perfusion after irradiation of random pattern flaps still remains a challenge. 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 irrad...

Descripción completa

Detalles Bibliográficos
Autores principales: Müller-Seubert, Wibke, Ostermaier, Patrick, Horch, Raymund E., Distel, Luitpold, Frey, Benjamin, Cai, Aijia, Arkudas, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880010/
https://www.ncbi.nlm.nih.gov/pubmed/35207725
http://dx.doi.org/10.3390/jpm12020237
_version_ 1784659067857272832
author Müller-Seubert, Wibke
Ostermaier, Patrick
Horch, Raymund E.
Distel, Luitpold
Frey, Benjamin
Cai, Aijia
Arkudas, Andreas
author_facet Müller-Seubert, Wibke
Ostermaier, Patrick
Horch, Raymund E.
Distel, Luitpold
Frey, Benjamin
Cai, Aijia
Arkudas, Andreas
author_sort Müller-Seubert, Wibke
collection PubMed
description Background: Assessment of tissue perfusion after irradiation of random pattern flaps still remains a challenge. 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: 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 (p < 0.05). Indocyanine green angiography showed no differences (p > 0.05) of the percentage of the nonperfused area between all days in group 1 and 3, but a decrease in group 2 in both the left and the right flaps. Infrared thermography and near-infrared reflectance-based imaging did not show evaluable differences. Conclusion: 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.
format Online
Article
Text
id pubmed-8880010
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-88800102022-02-26 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 Müller-Seubert, Wibke Ostermaier, Patrick Horch, Raymund E. Distel, Luitpold Frey, Benjamin Cai, Aijia Arkudas, Andreas J Pers Med Article Background: Assessment of tissue perfusion after irradiation of random pattern flaps still remains a challenge. 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: 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 (p < 0.05). Indocyanine green angiography showed no differences (p > 0.05) of the percentage of the nonperfused area between all days in group 1 and 3, but a decrease in group 2 in both the left and the right flaps. Infrared thermography and near-infrared reflectance-based imaging did not show evaluable differences. Conclusion: 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. MDPI 2022-02-08 /pmc/articles/PMC8880010/ /pubmed/35207725 http://dx.doi.org/10.3390/jpm12020237 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Müller-Seubert, Wibke
Ostermaier, Patrick
Horch, Raymund E.
Distel, Luitpold
Frey, Benjamin
Cai, Aijia
Arkudas, Andreas
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8880010/
https://www.ncbi.nlm.nih.gov/pubmed/35207725
http://dx.doi.org/10.3390/jpm12020237
work_keys_str_mv AT mullerseubertwibke intraandearlypostoperativeevaluationofmalperfusedareasinanirradiatedrandompatternskinflapmodelusingindocyaninegreenangiographyandnearinfraredreflectancebasedimagingandinfraredthermography
AT ostermaierpatrick intraandearlypostoperativeevaluationofmalperfusedareasinanirradiatedrandompatternskinflapmodelusingindocyaninegreenangiographyandnearinfraredreflectancebasedimagingandinfraredthermography
AT horchraymunde intraandearlypostoperativeevaluationofmalperfusedareasinanirradiatedrandompatternskinflapmodelusingindocyaninegreenangiographyandnearinfraredreflectancebasedimagingandinfraredthermography
AT distelluitpold intraandearlypostoperativeevaluationofmalperfusedareasinanirradiatedrandompatternskinflapmodelusingindocyaninegreenangiographyandnearinfraredreflectancebasedimagingandinfraredthermography
AT freybenjamin intraandearlypostoperativeevaluationofmalperfusedareasinanirradiatedrandompatternskinflapmodelusingindocyaninegreenangiographyandnearinfraredreflectancebasedimagingandinfraredthermography
AT caiaijia intraandearlypostoperativeevaluationofmalperfusedareasinanirradiatedrandompatternskinflapmodelusingindocyaninegreenangiographyandnearinfraredreflectancebasedimagingandinfraredthermography
AT arkudasandreas intraandearlypostoperativeevaluationofmalperfusedareasinanirradiatedrandompatternskinflapmodelusingindocyaninegreenangiographyandnearinfraredreflectancebasedimagingandinfraredthermography