1. Intraoperative Laser Speckle Contrast Imaging in DIEP Breast Reconstruction: A Prospective Case Series Study
- Author
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Johan Zötterman, Erik Tesselaar, Simon Farnebo, Stan Monstrey, Dries Opsomer, and Phillip Blondeel
- Subjects
INDOCYANINE GREEN ,lcsh:Surgery ,Perfusion scanning ,TRAM ,030230 surgery ,FLAP ,Contrast imaging ,law.invention ,03 medical and health sciences ,chemistry.chemical_compound ,Speckle pattern ,0302 clinical medicine ,law ,MICROCIRCULATORY EVALUATION ,PERFUSION ,Medicine and Health Sciences ,Medicine ,BLOOD-FLOW ,business.industry ,Kirurgi ,Blood flow ,lcsh:RD1-811 ,Laser ,chemistry ,030220 oncology & carcinogenesis ,Surgery ,Original Article ,Breast reconstruction ,business ,Nuclear medicine ,Indocyanine green ,Perfusion - Abstract
Introduction: Laser speckle contrast imaging (LSCI) is a laser-based perfusion imaging technique that recently has been shown to predict ischemic necrosis in an experimental flap model and predicting healing time of scald burns. The aims were to investigate perfusion in relation to the selected perforator during deep inferior epigastric artery perforator (DIEP) flap surgery, and to evaluate LSCI in assisting of prediction of postoperative complications. Methods: Twenty-three patients who underwent DIEP-procedures for breast reconstruction at 2 centers were included. Perfusion was measured in 4 zones at baseline, after raising, after anastomosis, and after shaping the flap. The perfusion in relation to the selected perforator and the accuracy of LSCI in predicting complications were analyzed. Results: After raising the flap, zone I showed the highest perfusion (65 +/- 10 perfusion units, PU), followed by zone II (58 +/- 12 PU), zone III (53 +/- 10 PU), and zone IV (45 +/- 10 PU). The perfusion in zone I was higher than zone III (P = 0.002) and zone IV (P < 0.001). After anastomosis, zone IV had lower perfusion than zone I (P < 0.001), zone II (P = 0.01), and zone III (P = 0.02). Flaps with areas
- Published
- 2019