Indocyanine Green Angiography Enhances Free Flap Surgery Outcomes

In a recent study, a team led by Sunil Choudhary aimed to explore the potential benefits of Indocyanine Green Angiography (ICGA) in free flap surgeries. The findings were published in the Indian Journal of Plastic Surgery.

Free flap surgery, a complex reconstructive procedure involving the transfer of tissue from one part of the body to another, is often used in cases of trauma, cancer, and congenital anomalies. However, flap failure due to insufficient blood supply can be a major concern, leading to partial flap loss and the need for re-exploration, both of which can significantly impact patient recovery and increase healthcare costs.

The study, conducted over a period of 12 years and comprising 877 consecutive free flaps, sought to assess and validate the role of ICGA in improving surgical outcomes and its cost-effectiveness. Additionally, the researchers introduced a new intraoperative protocol known as whole-body surface warming (WBSW) during strategic "microbreaks" to further enhance flap success rates.

The ICGA group, consisting of 438 patients, was compared to the historical No-ICGA group, comprising 439 patients, to evaluate the impact of ICGA on flap-related adverse outcomes. Statistical analysis revealed that the use of ICGA resulted in a significant reduction in partial flap loss and re-exploration rates when compared to the No-ICGA group.