Melanie D Hicks1, Alyssa K Ovaitt1, Jason C Fleming2, Anna G Sorace3,4,5, Patrick N Song4, Ameer Mansur3,4, Yolanda E Hartman Bs1, Eben L Rosenthal6, Jason M Warram1,5, Carissa M Thomas1,5. 1. Department of Otolaryngology - Head & Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA. 2. Liverpool Head and Neck Centre, Aintree University Hospital, University of Liverpool, Liverpool, UK. 3. Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, Alabama, USA. 4. Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA. 5. O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA. 6. Department of Otolaryngology - Head & Neck Surgery, Stanford University, Stanford, California, USA.
Abstract
BACKGROUND: Flap necrosis is a feared complication of reconstructive surgery. Current methods of prediction using Indocyanine green (ICG) lack specificity. IntegriSense750 is a fluorescence agent that binds sites of vascular remodeling. We hypothesized that IntegriSense750 better predicts flap compromise compared to ICG. METHODS: Fifteen mice underwent lateral thoracic artery axial flap harvest. Mice received an injection of ICG (n = 7) or IntegriSense750 (n = 8) daily from postoperative days (POD) 0-3 and were imaged daily. Mean signal-to-background ratios quantified the change in fluorescence as necrosis progressed. RESULTS: Mean signal-to-background ratio was significantly higher for IntegriSense750 compared to ICG on POD0 (1.47 ± 0.17 vs. 0.86 ± 0.21, p = 0.01) and daily through POD3 (2.12 ± 0.70 vs. 0.96 ± 0.29, p < 0.001). CONCLUSIONS: IntegriSense750 demonstrates increased signal-to-background ratio at areas of flap distress compared to ICG which may increase identification of flap necrosis and improve patient outcomes.
BACKGROUND: Flap necrosis is a feared complication of reconstructive surgery. Current methods of prediction using Indocyanine green (ICG) lack specificity. IntegriSense750 is a fluorescence agent that binds sites of vascular remodeling. We hypothesized that IntegriSense750 better predicts flap compromise compared to ICG. METHODS: Fifteen mice underwent lateral thoracic artery axial flap harvest. Mice received an injection of ICG (n = 7) or IntegriSense750 (n = 8) daily from postoperative days (POD) 0-3 and were imaged daily. Mean signal-to-background ratios quantified the change in fluorescence as necrosis progressed. RESULTS: Mean signal-to-background ratio was significantly higher for IntegriSense750 compared to ICG on POD0 (1.47 ± 0.17 vs. 0.86 ± 0.21, p = 0.01) and daily through POD3 (2.12 ± 0.70 vs. 0.96 ± 0.29, p < 0.001). CONCLUSIONS: IntegriSense750 demonstrates increased signal-to-background ratio at areas of flap distress compared to ICG which may increase identification of flap necrosis and improve patient outcomes.
Authors: Inge Van Hove; Tjing-Tjing Hu; Karen Beets; Tine Van Bergen; Isabelle Etienne; Alan W Stitt; Elke Vermassen; Jean H M Feyen Journal: Prog Retin Eye Res Date: 2021-03-26 Impact factor: 21.198
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