Clinical Application and Limitation of Indocyanine Green Fluorescent Angiography in Plastic and Reconstructive Surgery

靛氰綠（Indocyanine green）螢光血管造影在整形重建外科的臨床應用與限制

蔡昇霖(Sheng-Lin Tsai) ； 劉庭軒(Ting-Hsuan Liu) ； 侯智鈞(Chih-Chun Hou) ； 吳建緯(Chien-Wei Wu) ； 陳錫根(Shyi-Gen Chen) ； 曾元生(Yuan-Sheng Tzeng)

《臺灣整形外科醫學會雜誌》 31卷3期 (2022/09) Pp. 165-180

摘要

Background: Currently, the evaluation of flap perfusion is primarily based on clinical assessments. Objective methods have a high cost, complexity, and low sensitivity. Therefore, we introduce another method for perfusion evaluation that is easy to use, cost-effective, and can be used in real-time during the operation. Aim: To demonstrate the clinical application and potential of indocyanine green fluorescent angiography (ICGFA) in plastic and reconstructive surgery. Methods: We collected data on the application of ICGFA in plastic and reconstructive surgery performed at our hospital from January 1, 2017 to June 30, 2020. Data from approximately 80 patients were recorded. Results: In our hospital, ICGFA was used for flap design, flap perfusion evaluation, lymph mapping, replantation perfusion evaluation, and avulsion injury assessment. Conclusion: ICGFA is widely used in plastic surgery and helps surgeons make prompt and objective decisions. However, some limitations persist, such as vessel spasm, and further studies are required.

關鍵字

indocyanine green fluorescent angiography ； perfusion evaluation ； lymph mapping ； replantation ； avulsion injury

並列摘要

背景：近年來評估皮瓣循環狀況主要以臨床判斷為主。客觀的評估工具卻有昂貴、複雜或低靈敏度的問題。據此，我們本篇文章將介紹一種便利、經濟與即時的循環評估工具。目的及目標：本篇闡述靛氰綠（ICG）螢光血管造影在整形重建外科的臨床與未來應用。材料及方法：本研究蒐集2017年1月1日至2020年6月30日於本院整形與重建外科使用靛氰綠（ICG）螢光血管造影之80位患者進行分析。結果：本院靛氰綠（ICG）螢光血管造影應用於皮瓣設計、皮瓣循環評估、淋巴定位、斷指與撕脫傷評估。結論：靛氰綠（ICG）螢光血管造影協助醫師做出及時與客觀的判斷，然而仍有其限制，如血管攣縮，仍需未來更多研究。