Intraoperative Indocyanine Green Fluorescence Angiography during Minor Amputation of the Ischemic Foot

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  • Murao Naoki
    Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
  • Saito Tatsuya
    Center of Limb Salvage and Wound Care, Soen Central Hospital
  • Maeda Taku
    Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
  • Horiuchi Katsumi
    Department of Plastic and Reconstructive Surgery, Sapporo City General Hospital
  • Matsui Suguru
    Center of Limb Salvage and Wound Care, Soen Central Hospital
  • Yamamoto Yuhei
    Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

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Other Title
  • A Case Report

Description

Minor amputations for critical limb ischemia have been reported to confer an increased risk of postoperative skin necrosis or poor wound healing secondary to poor vascularity. Predicting wound healing in patients with critical limb ischemia is a focus of ongoing research. Indocyanine green fluorescence angiography is used to visualize tissue perfusion in various surgical fields. We sought to address this challenge and introduced indocyanine green fluorescence angiography during minor amputation in a patient with critical limb ischemia to evaluate perfusion of the wound tissue. Before wound closure, the parts of the skin flaps exhibiting fluorescence were preserved, while the non-fluorescent edges of the skin flaps were trimmed off. The trimmed skin was reused as a full-thickness skin graft. The postoperative course was uneventful. There was no wound dehiscence or flap necrosis, and the graft was completely incorporated. Indocyanine green fluorescence angiography was suggested to be effective for preventing postoperative wound dehiscence after minor amputation in a patient with critical limb ischemia.

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