PLASTIC AND RECONSTRUCTIVE SURGERY
Visualization of blood flow,
before, during and after surgery
WITH FLUORESCENCE IMAGING
REDUCED POSTOPERATIVE COMPLICATION RATE
Regardless of the surgeon’s experience, the clinical assessment of the perfusion remains subjective and often unsubstantial in predicting postoperative complications. Fluorescence imaging provides qualitative and quantitative information for a better evaluation of the perfusion. This information enables the surgeon to carry out an objective analysis of the perfusion in real-time, the fluorescence signal being representative of this tissue perfusion.
Fluorescence angiography will enable surgeons to:
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Identify flap perforators preoperatively
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Check the vascular anastomoses and flap perfusion in real-time
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Assess tissue perfusion postoperatively
Fluorescence angiography is performed with FLUOBEAM®, combined with the intravenous injection of indocyanine green (ICG) during the surgery and FLUOBEAM® displays on screen clear images of the blood flow dynamics.
The images displayed by Fluobeam® provide additional information, enabling the surgeon to improve his or her understanding so as to prevent eventual postoperative complications.
FLUOBEAM® IN ACTION
Breast reconstruction
FLUOBEAM® enables surgeons to assess the quality of tissue perfusion (flaps or skin after skin sparing mastectomy) in real-time and to modify his or her surgery to minimize complication risks.
During reconstructive surgery involving autologous flaps (free or pedicle), assessment of flap perfusion is essential in order to avoid postoperative complications such as total or partial skin or fat necrosis.
Head and neck reconstruction
During reconstructive surgery, fluorescence imaging allows surgeons to check the flap perfusion in real-time and to reduce the risk of postoperative complications such as partial or total flap necrosis. FLUOBEAM® enables surgeons to ensure good vascularization of the tissue
In this indication, fluorescence imaging can also be used for postoperative flap evaluation to anticipate potential complications such as venous thrombosis.
SURGEONS' HONOR
Dr Assaf Zeltzer
Plastic, Reconstructive and Aesthetic Surgery, UZ Brussel, Brussels, Belgium
'When you do the imaging and you see something, ICG is not going to lie, so you see as far you can take your flap and how far you can take it safely.'
Dr. Georges Bettega
Head and Neck Reconstruction Surgery, Centre hospitalier d’Annecy, Annecy, France
'The interest is real to anticipate the occurrence of an accident, the main risk being that a vein or an artery clogs and then provokes a thrombosis. The sooner we intervene on a thrombosis, the better chance we have to save the flap. '
PUBLICATIONS
> Bettega G. et al. Fluorescent Angiography for Flap Planning and Monitoring in Reconstructive Surgery. Chapter 32; 301-310.
Fluorescence Imaging for Surgeons: Concepts and Applications. 2015.F.D. Dip et al. (eds.)
>
H
itier M. et al. Indocyanine green fluorescence angiography for free flap monitoring: a pilot study.
Journal of Cranio-Maxillofacial Surgery 2016
JPRAS 2017