Intraoperative near-infrared fluorescence imaging in perforator flap reconstruction: current research and early clinical experience.
Despite recent advances in perforator flap reconstruction, there can be significant variability in vessel size and location. Although preoperative evaluation may provide valuable information, real-time intraoperative methods have the potential to provide the greatest benefit. Our laboratory has developed the Fluorescence-Assisted Resection and Exploration (FLARE) near-infrared (NIR) fluorescence imaging system for intraoperative visualization of details of the underlying vasculature. The FLARE system uses indocyanine green, a safe and reliable NIR fluorophore already FDA-approved for other indications. The system has been optimized in large-animal models for the identification of perforator size, location, and perfusion and has also been translated to the clinic for use during breast reconstruction after mastectomy. In this article, we review our preclinical and clinical data, as well as literature describing the use of similar NIR fluorescence imaging systems in plastic and reconstructive surgery.
Lee
Bernard T
BT
Division of Plastic and Reconstructive Surgery, Boston, Massachusetts, USA.
Matsui
Aya
A
Hutteman
Merlijn
M
Lin
Samuel J
SJ
Winer
Joshua H
JH
Laurence
Rita G
RG
Frangioni
John V
JV
D034861:Abdominal Wall / Q000098:blood supply*; D000818:Animals; D002680:Chin / Q000098:blood supply*; D003952:Diagnostic Imaging / Q000379:methods*; D019074:Epigastric Arteries; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007259:Infrared Rays; D007430:Intraoperative Care; D016462:Mammaplasty; D023421:Models, Animal; D010865:Pilot Projects; D013524:Surgical Flaps / Q000098:blood supply*; D013552:Swine