Work

Salvage of anterolateral thigh (ALT) flap with indocyanine green assessment of a flap pedicle and subsequent perforator-to-perforator anastomosis

Year: 2024

Type: article

Abstract: Indocyanine green (ICG) fluorescence angiography has emerged as an intraoperative method to accurately assess real-time tissue vascularity, perfusion and anastomotic patency in flap surgery. We illustrate a complex case of elbow reconstruction in an elderly patient with a free anterolateral thigh flap, which relied on intraoperative ICG to evaluate the flap pedicle and map the site of arterial occlusion. Supermicrosurgical instrumentation was employed to perform complex perforator-to-perforator anastomosis following resection of the vascular site of the lesion. These unique applications in a patient of known surgical risk enabled immediate flap salvage, and after 6 months postoperatively, the flap remained healthy with adequate wound healing.

Source: JPRAS Open

DOI: 10.1016/j.jpra.2024.10.001

Authors: Petko Shtarbanov, Nianhe Luo, Ahmed Yassin, Dariush Nikkhah

Institutions: University College London, Royal Free London NHS Foundation Trust

Language: English

Topic: Reconstructive Surgery and Microvascular Techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,920