ICG dye is a water-soluble tricarbocyanine dye that was originally developed by the Eastman Kodak company for use in infrared photography. The true impact of the technology on the understanding of our specialty is only beginning to be felt. Most importantly, use of the dye and the laser has been proved to be safe in humans. For the first time, surgeons could immediately see perfusion in the operated tissues multiple times throughout a procedure as needs changed. Although used experimentally in the late 1990s, by the mid 2000s the technology was already in regular use by some plastic surgeons. Advances in technology have allowed the surgeon to use fluorescent angiography in the operating room in real time, under complete control of the surgeon. The technology is based on indocyanine green (ICG) dye that absorbs light in the near-infrared (NIR) spectrum. The technology is easy to use in the hands of the operating surgeon and is safe for the patient, as it requires no radiation exposure.įluorescent angiography is a simple and effective real-time tool for measurement of tissue perfusion both in and out of the operating room. It has multiple uses including: (1) identifying perforating vessels during flap planning (2) locating primary and secondary angiosomes within a prepared flap (3) as an aid in decision making for tissue debridement and flap creation (4) intraoperative evaluation of microanastomoses (5) postoperative flap monitoring, and (6) documentation of perfusion. Fluorescent angiography is a simple and effective real-time tool for measurement of tissue perfusion both in and out of the operating room.
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