OBJECTIVE: Amputations of the lower extremity due to irreversible ischemic tissue loss are performed as distally as possible. Therefore, oftentimes wound-healing disorders develop, requiring additional surgical treatment. METHODS: The amputations stumps of 10 patients with irreversible ischemic tissue loss due to arteriosclerosis were investigated within 72 hours postoperatively with indocyanine green (ICG) fluorescence. RESULTS: For 6 of the investigated stumps, no perfusion deficit could be seen through fluorescence angiography. All stumps displayed primary healing. In the fluorescence angiography of 3 amputations, stump perfusions deficits predicted later tissue necrosis and had to be amputated again in a second operation. One amputation wound showed a small ICG perfusion deficit that represented a blood clot. CONCLUSION: Indocyanine green fluorescence angiography allows a perfusion analysis of amputation stumps and therefore a prediction of the expected tissue necrosis. This tool may allow reliable prediction of amputation level.
OBJECTIVE: Amputations of the lower extremity due to irreversible ischemic tissue loss are performed as distally as possible. Therefore, oftentimes wound-healing disorders develop, requiring additional surgical treatment. METHODS: The amputations stumps of 10 patients with irreversible ischemic tissue loss due to arteriosclerosis were investigated within 72 hours postoperatively with indocyanine green (ICG) fluorescence. RESULTS: For 6 of the investigated stumps, no perfusion deficit could be seen through fluorescence angiography. All stumps displayed primary healing. In the fluorescence angiography of 3 amputations, stump perfusions deficits predicted later tissue necrosis and had to be amputated again in a second operation. One amputation wound showed a small ICG perfusion deficit that represented a blood clot. CONCLUSION:Indocyanine green fluorescence angiography allows a perfusion analysis of amputation stumps and therefore a prediction of the expected tissue necrosis. This tool may allow reliable prediction of amputation level.
Authors: Jarmo T Alander; Ilkka Kaartinen; Aki Laakso; Tommi Pätilä; Thomas Spillmann; Valery V Tuchin; Maarit Venermo; Petri Välisuo Journal: Int J Biomed Imaging Date: 2012-04-22
Authors: Andreas Hackethal; Markus Hirschburger; Sven Oliver Eicker; Thomas Mücke; Christoph Lindner; Olaf Buchweitz Journal: Geburtshilfe Frauenheilkd Date: 2018-01-22 Impact factor: 2.915
Authors: Judith E K R Hentzen; Steven J de Jongh; Patrick H J Hemmer; Willemijn Y van der Plas; Gooitzen M van Dam; Schelto Kruijff Journal: J Surg Oncol Date: 2018-06-24 Impact factor: 3.454