Delphi survey of intercontinental experts to identify areas of consensus on the use of indocyanine green angiography for tissue perfusion assessment during plastic and reconstructive surgery
Schols, Rutger M. (Maastricht University Medical Center)
Dip, Fernando (Hospital de Clínicas José de San Martín)
Lo Menzo, Emanuele (Cleveland Clinic Florida)
Haddock, Nicholas T. (University of Texas Southwestern Medical Center)
Landin, Luis (Hospital Universitario La Paz (Madrid))
Lee, Bernard T. (Harvard Medical School)
Malagón, Paloma (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Masià, Jaume (Institut d'Investigació Biomèdica Sant Pau)
Mathes, David W. (University of Colorado)
Nahabedian, Maurice Y. (Center for Plastic Surgery)
Neligan, Peter C. (University of Washington)
Newman, Martin I. (Cleveland Clinic Florida)
Phillips, Brett T. (Duke University Hospital)
Pons, Gemma (Institut d'Investigació Biomèdica Sant Pau)
Pruimboom, Tim (Maastricht University Medical Center)
Qiu, Shan Shan (Maastricht University Medical Center)
Ritschl, Lucas M. (Klinikum rechts der Isar)
Rozen, Warren M. (Monash University. Peninsula Campus)
Saint-Cyr, Michael (MD Anderson Cancer Center)
Song, Seung Yong (Yonsei University College of Medicine)
van der Hulst, René R.W.J. (Maastricht University Medical Center)
Venturi, Mark L. (VCU School of Medicine INOVA)
Wongkietkachorn, Apinut (Mae Fah Luang University)
Yamamoto, Takumi (National Center for Global Health and Medicine)
White, K.P. (ScienceRight Research Consulting Services)
Rosenthal, Raul J. (Cleveland Clinic Florida)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	In recent years, indocyanine green angiography (ICG-A) has been used increasingly to assist tissue perfusion assessments during plastic and reconstructive surgery procedures, but no guidelines exist regarding its use. We sought to identify areas of consensus and non-consensus among international experts on the use of ICG-A for tissue-perfusion assessments during plastic and reconstructive surgery. A two-round, online Delphi survey was conducted of 22 international experts from four continents asking them to vote on 79 statements divided into five modules: module 1 = patient preparation and contraindications (n = 11 statements); module 2 = ICG administration and camera settings (n = 17); module 3 = other factors impacting perfusion assessments (n = 10); module 4 = specific indications, including trauma debridement (n = 9), mastectomy skin flaps (n = 6), and free flap reconstruction (n = 8); and module 5 = general advantages and disadvantages, training, insurance coverage issues, and future directions (n = 18). Consensus was defined as ≥70% inter-voter agreement. Consensus was reached on 73/79 statements, including the overall value, advantages, and limitations of ICG-A in numerous surgical settings; also, on the dose (0. 05 mg/kg) and timing of ICG administration (∼20-60 seconds preassessment) and best camera angle (61-90) and target-to-tissue distance (20-30 cm). However, consensus also was reached that camera angle and distance can vary, depending on the make of camera, and that further research is necessary to technically optimize this imaging tool. The experts also agreed that ambient light, patient body temperature, and vasopressor use impact perfusion assessments. ICG-A aids perfusion assessments during plastic and reconstructive surgery and should no longer be considered experimental. It has become an important surgical tool.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Surgery (United States), Vol. 172 Núm. 6 (december 2022) , p. S46-S53, ISSN 1532-7361

DOI: 10.1016/j.surg.2022.04.015
PMID: 36427930

8 p, 313.2 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
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Articles > Published articles