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CC BY-NC 4.0 · Arch Plast Surg 2019; 46(04): 318-323
DOI: 10.5999/aps.2018.01536
Original Article

Indocyanine green fluorescence videoangiography for reliable variations of supraclavicular artery flaps

Yushi Suzuki 
Department of Plastic and Reconstructive Surgery, University of the Ryukyus, Okinawa, Japan
,
Yusuke Shimizu 
Department of Plastic and Reconstructive Surgery, University of the Ryukyus, Okinawa, Japan
,
Shogo Kasai 
Department of Plastic and Reconstructive Surgery, University of the Ryukyus, Okinawa, Japan
,
Shun Yamazaki 
Department of Plastic and Reconstructive Surgery, University of the Ryukyus, Okinawa, Japan
,
Masashi Takemaru 
Department of Plastic and Reconstructive Surgery, University of the Ryukyus, Okinawa, Japan
,
Takuya Kitamura 
Department of Plastic and Reconstructive Surgery, University of the Ryukyus, Okinawa, Japan
,
Saori Kawakami 
Department of Plastic and Reconstructive Surgery, University of the Ryukyus, Okinawa, Japan
,
Takeshi Tamura 
Department of Plastic and Reconstructive Surgery, University of the Ryukyus, Okinawa, Japan
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Background Pedicled flaps are useful for reconstructive surgery. Previously, we often used vascularized supraclavicular flaps, especially for head and neck reconstruction, but then shifted to using thoracic branch of the supraclavicular artery (TBSA) flaps. However, limited research exists on the anatomy of TBSA flaps and on the use of indocyanine green (ICG) fluorescence videoangiography for supraclavicular artery flaps. We utilized ICG fluorescence videoangiography to harvest reliable flaps in reconstructive operations, and describe the results herein.

Methods Data were retrospectively reviewed from six patients (five men and one woman: average age, 54 years; range, 48–60 years) for whom ICG videoangiography was performed to observe the skin perfusion of a supraclavicular flap after it was raised. Areas where the flap showed good enhancement were considered to be favorable for flap survival. The observation of ICG dye indicated good skin perfusion, which is predictive of flap survival; therefore, we trimmed any areas without dye filling and used the remaining viable part of the flap.

Results The flaps ranged in size from 13×5.5 cm to 17×6.5 cm. One patient received a conventional supraclavicular flap, four patients received a TBSA flap, and one patient received a flap that was considered to be intermediate between a supraclavicular flap and a TBSA flap. The flaps completely survived in all cases, and no flap necrosis was observed.

Conclusions The TBSA flap is very useful in reconstructive surgery, and reliable flaps could be obtained by using ICG fluorescence videoangiography intraoperatively.

Keywords

Reconstructive surgical procedure - Surgical flaps - Indocyanine green


Publication History

Received: 23 December 2018

Accepted: 24 May 2019

Article published online:
28 March 2022

© 2019. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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