title: Chromophores in operative surgery: Current practice and rationalized development.
abstract: Chromophore-containing molecules feature extensively in surgical practice, with synthetic dyes gaining popularity over endogenous optical adjuncts. New applications for chromophores in diagnostics and operative treatment exploit unique chemical structures suited for illuminating target tissues beyond the visual spectrum, ranging from ultraviolet (UV) to near-infrared (NIR). This review outlines the rationale for surgical chromophore application, the weaknesses and risks in each class of these compounds, and areas of foreseeable potential for employment of specialized contrast agents.
  
  
  
  An English-language literature search applied the following Boolean Search String: "dye OR Lake OR Stain OR chromophore" AND "tox$ OR terato* OR carcino$ OR Allerg$ OR surg$ OR clinic" using EMBASE, PUBMED, PUBMED central and OVIDSp, with back-referencing through Web of Knowledge™.
  
  
  
  Based on the primary literature, this study proposes a surgically relevant classification system of chromophores in current use, which facilitates risk/benefit consideration for the surgeon who employs them, and which facilitates clinically oriented development.
  
  
  
  The next stage of development for optically active surgical adjuncts must address practical constraints whilst minimizing risks of adverse effects. Exploiting the technology's full potential also requires improvements in the usefulness of imagery equipment.
authors.affiliation: Swansea University Medical School, Swansea University, Singleton Campus, UK; School of Management, Bay Campus, Swansea University, UK; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK. Electronic address: e.a.p.azzopardi@swansea.ac.uk.
authors.forename: Ernest A
authors.initials: EA
authors.lastname: Azzopardi
authors.affiliation: Swansea University Medical School, Swansea University, Singleton Campus, UK.
authors.forename: Siân-Eleri
authors.initials: SE
authors.lastname: Owens
authors.affiliation: The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK.
authors.forename: Maxwell
authors.initials: M
authors.lastname: Murison
authors.affiliation: Swansea University Medical School, Swansea University, Singleton Campus, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rees
authors.affiliation: Swansea University Medical School, Swansea University, Singleton Campus, UK.
authors.forename: M
authors.initials: M
authors.lastname: Anne Sawhney
authors.affiliation: Swansea University Medical School, Swansea University, Singleton Campus, UK; School of Management, Bay Campus, Swansea University, UK.
authors.forename: Lewis W
authors.initials: LW
authors.lastname: Francis
authors.affiliation: School of Management, Bay Campus, Swansea University, UK.
authors.forename: R
authors.initials: R
authors.lastname: Sofia Rodrigues Teixeira
authors.affiliation: Enterprise and Innovation Group, Institute for Life Sciences, Swansea University, Singleton Campus, UK.
authors.forename: Marc
authors.initials: M
authors.lastname: Clement
authors.affiliation: Swansea University Medical School, Swansea University, Singleton Campus, UK; School of Management, Bay Campus, Swansea University, UK.
authors.forename: R
authors.initials: R
authors.lastname: Steven Conlan
authors.affiliation: Swansea University Medical School, Swansea University, Singleton Campus, UK; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK.
authors.forename: Iain S
authors.initials: IS
authors.lastname: Whitaker
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced; D000818:Animals; D004396:Coloring Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry* / Q000493:pharmacokinetics; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry* / Q000493:pharmacokinetics; D004342:Drug Hypersensitivity / Q000209:etiology; D006801:Humans; D007259:Infrared Rays; D008027:Light; D009369:Neoplasms / Q000139:chemically induced; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods*; D014466:Ultraviolet Rays
chemical_list: D004396:Coloring Agents; D003287:Contrast Media
keywords: Azo derivative; Bonney's blue; Chromophore; Contrast agent; Dye; Fluorophore; Indocyanine green; Infrared; Melanin; Methylene blue; Optical adjunct; Patent Blue V; Phenothiazine; Pigment; Porphyrin; Stain; Triarylmethane; Triphenylmethane; Ultraviolet; lymphadenectomy; optical; sentinel lymph node biopsy; surgery