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Novruzbekov MS, Lutsyk KN, Olisov OD, Magomedov KM, Kazymov BI, Alekberov KF, Akhmedov AR, Yaremin BI. [Indocyanine green in liver transplantation]. Khirurgiia (Mosk) 2023:63-72. [PMID: 37682549 DOI: 10.17116/hirurgia202309263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
The purpose of this study was to evaluate the first own experience of using indocyanine green (ICG) in liver transplantation compared to literature data and to determine its potential for clinical practice. Liver transplantation is an effective option for patients with end-stage disease, but this procedure is associated with many problems such as graft rejection, graft dysfunction, surgical risk and postoperative management. Modern methods for assessing graft function have their limitations, so a more efficient method is needed. According to this review, ICG fluorescence is valuable for effective intraoperative blood flow control, assessment of graft function, intraoperative and postoperative monitoring of clinical status. ICG fluorescence can also predict clinical status of patients at all stages of liver transplantation. Routine ICG fluorescence method is advisable in liver transplantation to improve outcomes and optimize treatment process.
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Affiliation(s)
- M S Novruzbekov
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - K N Lutsyk
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - O D Olisov
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - K M Magomedov
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - B I Kazymov
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - K F Alekberov
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - A R Akhmedov
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
| | - B I Yaremin
- Sklifosovsky Research Institute for Emergency Care, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
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Salgarello M, Pino VS, Pagliara DM, Visconti G. Preventing Soft Tissue Complications in Secondary Aesthetic Breast Surgery Using Indocyanin Green Angiography. Aesthet Surg J 2022; 43:665-672. [PMID: 36242548 PMCID: PMC10184940 DOI: 10.1093/asj/sjac261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Secondary cosmetic breast surgery after primary augmentation with implant can be associated with an increased risk of adverse events. Partial/complete nipple areolar complex (NAC) necrosis is particularly feared. In this preliminary study, the authors propose the use of Indocyanine Green (ICG) angiography in order to assess the blood supply of breast tissue after implant removal. OBJECTIVES The main objective is to prevent skin and gland necrosis in revision breast surgery. METHODS We performed a retrospective comparative analysis of 33 patients undergoing secondary breast surgery between 2018 and 2021 by a single surgeon (M.S.). Breast tissue perfusion was assessed in 16 patients by intraoperative ICG-angiography at the end of implant removal and possible capsulectomy. Non-stained/non-fluorescent areas were judged to be low perfusion areas and were excised with short scar mastopexy. RESULTS In the ICG-angiography group, 7 patients (44%) showed an area of poor perfusion along the inferior pole, all of these patients underwent subglandular breast augmentation. Resection of the poor perfusion areas allowed an uneventful postoperative course. In the non ICG-angiography group (17 patients), 5 patients experienced vertical scar dehiscence/necrosis. We found a statistically significant association between non-ICG angiography group and vertical scar dehiscence/necrosis, and also between vertical scar dehiscence/necrosis and subglandular implant placement (P-value = 0.04). CONCLUSIONS Safer secondary surgery can be offered to patients undergoing secondary aesthetic breast procedures, especially when the first augmentation surgery is unknown e.g. implant plane, type of pedicle used, the implant is large and subglandular, and capsulectomy is performed.
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Affiliation(s)
- Marzia Salgarello
- Department of Plastic Surgery, Dipartimento per la Salute della Donna, del Bambino e di Sanità Pubblica - Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS - Università Cattolica del "Sacro Cuore" Rome, Italy
| | - Valentina Sara Pino
- Department of Plastic Surgery, Dipartimento per la Salute della Donna, del Bambino e di Sanità Pubblica - Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS - Università Cattolica del "Sacro Cuore" Rome, Italy
| | | | - Giuseppe Visconti
- Department of Plastic Surgery, Dipartimento per la Salute della Donna, del Bambino e di Sanità Pubblica - Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS - Università Cattolica del "Sacro Cuore" Rome, Italy
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Atiyeh BS, Chahine F. Comment on Nipple-Sparing Mastectomy and Immediate Implant-Based Reconstruction With or Without Skin Reduction in Patients with Large Ptotic Breasts: A Case-Matched Analysis. Aesthetic Plast Surg 2021; 45:1365-1366. [PMID: 33403409 DOI: 10.1007/s00266-020-02056-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Bishara S Atiyeh
- Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Beirut, Lebanon
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Kühn F, Blohmer JU, Karsten MM. Intraoperative indocyanine green fluorescence imaging in breast surgery. Arch Gynecol Obstet 2020; 302:463-472. [PMID: 32447448 PMCID: PMC7321898 DOI: 10.1007/s00404-020-05582-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 05/04/2020] [Indexed: 11/27/2022]
Abstract
Background Since postoperative complications after reconstructive breast surgery are often related to drastic increases of patient suffering and treatment costs, several devices were developed in order to avoid them. In this respect, the intraoperative fluorescence angiography with indocyanine green (ICG) provides promising results by detecting ischemic skin intraoperatively. Methods Women who underwent reconstructive breast surgery at the breast center at Charité between April and December 2017 were included in the analysis. General patient characteristics, medical history, type of surgery, as well as postoperative parameters, complications and patient reported outcomes were compared between patients operated using ICG fluorescence angiography and conventionally operated patients. Results Among 68 patients with breast reconstruction 36 (52.9%) were operated with the ICG angiography device and 32 (47.1%) without. No significant differences regarding patient demographics, medical history, and surgical procedure were found. Wound healing disorders occurred in 11.1% of the ICG group and in 9.4% of the control group. About 11% of both groups developed major complications which required revision surgery. Complication rates and patient reported outcome did not differ significantly. Across both groups, only the risk factor resection weight (≥ 500 g) was significantly associated with wound healing disorders (RR = 6.80; 95%CI 1.93–23.81; p = 0.022). Conclusion The purchase of a device for intraoperative ICG angiography might not be reasonable for every breast center. Further research in a larger cohort and prospective manner should be done to determine if the addition of ICG to breast reconstructive surgery in the German setting really leads to improved patient care.
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Affiliation(s)
- Friedrich Kühn
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Jens-Uwe Blohmer
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Maria Margarete Karsten
- Department of Gynecology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
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David V, Christou N, Etienne P, Almeida M, Roux A, Taibi A, Mathonnet M. Extravasation of Noncytotoxic Drugs. Ann Pharmacother 2020; 54:804-814. [PMID: 32054312 DOI: 10.1177/1060028020903406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objective: Commonly used drugs may be dangerous in case of extravasation. The lack of information from health care teams can lead to delays in both diagnosis and treatments. This review aims at alerting health care professionals about drugs and risk factors for extravasation and outlines recommendations for the diagnosis and treatment of extravasation. Data Source: A literature search of MEDLINE/PubMed, Scopus, the Cochrane Library, and Google Scholar was performed from 2000 to December 2019 using the following terms: extravasation, central venous line, peripheral venous line, irritant, and vesicant. Study Selection and Data Extraction: Overall, 140 articles dealing with drug extravasation were considered potentially relevant. Each article was critically appraised independently by 2 authors, leading to the inclusion of 80 relevant studies, guidelines, and reviews. Articles discussing incidents of extravasation in the neonatal and pediatric population of patients were excluded. Data Synthesis: Training of health care teams and writing care protocols are important for an optimal management of extravasations. A prompt consultation should be achieved by a specialist surgeon. The surgical procedure, if necessary, will consist of wound debridement followed by an abundant lavage. Relevance to Patient Care and Clinical Practice: This review discusses the management of drug extravasations according to their mechanism(s) of toxicity on tissues. It highlights the importance of a close monitoring of patients and the training of health care teams likely to face this type of adverse event. Conclusions: Extravasations still contribute to significant morbidity and mortality. A good knowledge of risk factors and the implementation of easily and quickly accessible standardized care protocols are 2 key elements in both prevention and treatment of extravasations.
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Affiliation(s)
| | - Niki Christou
- Endocrine, General and Digestive Surgery Department, CHU of Limoges, Limoges, France
| | | | | | - Alexia Roux
- Endocrine, General and Digestive Surgery Department, CHU of Limoges, Limoges, France
| | - Abdelkader Taibi
- Endocrine, General and Digestive Surgery Department, CHU of Limoges, Limoges, France
| | - Muriel Mathonnet
- Endocrine, General and Digestive Surgery Department, CHU of Limoges, Limoges, France
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Chen Y, Mu L. [Application progress of indocyanine green angiography in lymphedema]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2019; 33:1589-1592. [PMID: 31823564 DOI: 10.7507/1002-1892.201904104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To summarize the application progress of indocyanine green (ICG) angiography in diagnosis and treatment of lymphedema. Methods The literature related to dynamic imaging tracing of lymphedema at home and abroad was reviewed extensively. And the research status and progress of ICG angiography in diagnosis and treatment of lymphedema were retrospectively analyzed. Results ICG angiography can be used as the gold standard for the diagnosis of lymphedema at present and the classification of lymphedema severity, selection of surgical incisions and methods, and intraoperative operation. It can also be used to observe lymphatic drainage and regeneration within 1.5 cm of subcutaneous and determine the prognosis. Conclusion Compared with traditional methods, ICG angiography has more obvious advantages and value in diagnosis and treatment of lymphedema. However, it also has problems such as slow development speed and difficulty in developing deep lymphatic vessels (nodes).
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Affiliation(s)
- Yujie Chen
- Plastic and Aesthetic Surgery Department, Peking University People's Hospital, Beijing, 100044, P.R.China
| | - Lan Mu
- Plastic and Aesthetic Surgery Department, Peking University People's Hospital, Beijing, 100044,
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[Acellular dermal matrix and synthetic mesh in implant-based immediate breast reconstruction: Current concepts]. ACTA ACUST UNITED AC 2019; 47:311-316. [PMID: 30738819 DOI: 10.1016/j.gofs.2019.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Indexed: 11/23/2022]
Abstract
The use of acellular dermal matrices and synthetic meshes is gaining popularity in direct-to-implant breast reconstruction, allowing the complete coverage of the prosthesis with greater pocket control and improved cosmesis. In this concise review, we present the advantages of acellular dermal matrices and resorbable or nonresorbable synthetic meshes in implant-based breast reconstruction, we discuss the risk of postoperative complications, and we raise their contribution in the growing interest of prepectoral breast reconstruction.
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Rimareix F, Sarfati B, Leymarie N, Alkhashnam H, Honart JF, Tran De Frémicourt K, Conversano A, Struk S, Schaff JB, Bennis Y, Mazouni C, Delaloge S, Rivera S, Kolb F. [Mastectomy and immediate reconstruction: Indications, techniques and decision algorithm]. ANN CHIR PLAST ESTH 2018; 63:542-544. [PMID: 30144962 DOI: 10.1016/j.anplas.2018.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 07/12/2018] [Indexed: 01/22/2023]
Abstract
Immediate breast reconstruction indications extend to infiltrating carcinomas, due to new matrix implant coverage techniques and the development of perforator flaps. These techniques allow adjuvant treatments. However, the decision of immediate reconstruction must be discussed with the oncological multidisciplinary team and the benefits/risks must also be evaluated in relation to the morphology of the patients and their co-morbidities. The chosen type of mastectomy: conventional or skin sparing and/or nipple sparing depends on the shape and volume of the breast, the localization of the tumor in the breast and the distance from the nipple areola complex (NAC). We describe an algorithm to allow, in the case of therapeutic mastectomy with or without adjuvant radiotherapy, an immediate reconstruction with implants or free or pedicled flaps.
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Affiliation(s)
- F Rimareix
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - B Sarfati
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - N Leymarie
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - H Alkhashnam
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - J F Honart
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - K Tran De Frémicourt
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - A Conversano
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - S Struk
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - J-B Schaff
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - Y Bennis
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - C Mazouni
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - S Delaloge
- Département d'oncologie médicale, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - S Rivera
- Département de radiothérapie, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - F Kolb
- Département de chirurgie plastique, Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
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