title: Indocyanine green near-infrared laser angiography predicts timing for the division of a forehead flap.
abstract: BACKGROUND
  Reconstruction with flaps requiring delayed division remains common, even with increasing use of free tissue transfer. Patient quality of life and function are significantly decreased during the delay period. Delay could be minimized by developing methods to reliably determine when the flap has developed sufficient vascular supply to undergo successful division. We report the use of laser angiography to determine the appropriate time for division of a forehead flap pedicle.
  
  
  METHODS
  The patient who had risk factors for microvascular disease underwent near-infrared laser angiography using indocyanine green on postoperative day 21 to assess vascular perfusion of the flap. Although traditional clinical examination indicated the flap was not adequately perfused, laser angiography revealed perfusion to all areas of the flap, so the pedicle was divided.
  
  
  RESULTS
  Pedicle division was successful, with no epidermolysis or necrosis.
  
  
  CONCLUSIONS
  Near-infrared laser angiography with indocyanine green can assess perfusion status of the entire flap and inform the decision to divide the flap in an objective manner.
authors.forename: Joani M
authors.initials: JM
authors.lastname: Christensen
authors.forename: Donald P
authors.initials: DP
authors.lastname: Baumann
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Myers
authors.forename: Kate
authors.initials: K
authors.lastname: Buretta
authors.forename: Justin M
authors.initials: JM
authors.lastname: Sacks