Effectiveness of intraoperative indocyanine-green fluorescence angiography during inguinal lymph node dissection for skin cancer to prevent postoperative wound dehiscence.

PURPOSE: The incidence of postoperative wound dehiscence following inguinal lymph node dissection (ILND) is higher than that in other anatomic regions. To prevent wound dehiscence, intraoperative interventions, such as trimming off the ischemic part of the flap before wound closure based on indocyanine-green (ICG) fluorescence angiography, have been introduced in our institute. This report describes a retrospective clinical study of 17 cases, and the objective of the study was to evaluate the clinical efficacy of intraoperative intervention using ICG fluorescence angiography.
METHOD: A total of 17 patients who underwent ILND for skin cancer between 2009 and 2013 at our institute were reviewed retrospectively, and the significance of variables, including intervention using ICG fluorescence angiography, was evaluated using Fisher's exact test.
RESULTS: There were nine cases of wound dehiscence, and two of these cases required a secondary skin graft. Only one case of wound dehiscence developed in the eight patients who underwent intervention based on ICG fluorescence angiography. This procedure was a significant factor influencing the risk of wound dehiscence (p = 0.003) in our study.
CONCLUSION: Although this was a small case series, intraoperative intervention based on ICG fluorescence angiography was effective for preventing postoperative wound dehiscence after ILND.