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Fluorescence Angiography in the Assessment of DIEP Flap Perfusion

Not Applicable
Completed
Conditions
Breast Cancer
Vascularization
Fat Necrosis
Interventions
Procedure: Tailoring the flap according to ICG Angiography assessment
Procedure: Tailoring the flap according to clinical assessment
Registration Number
NCT02759796
Lead Sponsor
Instituto de Investigación Hospital Universitario La Paz
Brief Summary

It is a single-center, prospective, randomized and controlled study focused in microsurgical autologous breast reconstruction. It involves applying indocyanine green (ICG) angiography for the study of the vascularization of DIEP flaps. The aim of the study is to determine whether there are differences in complications and aesthetic results when ICG is used to discard the poorly vascularized areas of the flap. The study includes adult women undergoing unilateral DIEP flap breast reconstruction. The calculated sample size is 60 patients. There are two groups. In group 1, the investigators use the usual clinical criteria to discard the poorly vascularized areas of the flap. In group 2, the investigators use the ICG to shape the flap.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
60
Inclusion Criteria
  • Mastectomized adult female patient
  • Abdominal flap unilateral breast reconstruction indication
  • Alloplastic breast reconstruction sequelae
  • Enough amount of abdominal dermofat tissue to shape a breast with a primary closure of the donor site
Exclusion Criteria
  • DIEP flap bilateral breast reconstruction indication
  • Previous abdominoplasty surgery
  • Untreated psychiatric disease
  • Untreated infection
  • Indocyanine green or iodine hypersensitivity
  • Hyperthyroidism, thyroid adenoma or thyroid autonomy
  • Any concomitant disease or condition that, in the opinion of the investigator, can make the patient unsuitable to receive a microsurgical technique or to join the research.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Angiography assessment of flap perfusionTailoring the flap according to ICG Angiography assessmentTailoring the flap according to ICG Angiography assessment of flap perfusion
Clinical assessment of flap perfusionTailoring the flap according to clinical assessmentTailoring the flap according to clinical assessment of flap perfusion
Primary Outcome Measures
NameTimeMethod
Number of participants with fat necrosis as assessed by physical examinationSix months postoperatively
Number of participants with fat necrosis as assessed by ultrasonographySix months postoperatively
Secondary Outcome Measures
NameTimeMethod
ICG security (Number of participants with tachycardia, exanthema and anaphylactic shock as assessed by physical examination and intraoperative monitoring)Intraoperatively
Number of participants with wound infection as assessed by physical examinationFrom one day postoperatively to two weeks postoperatively
Number of participants with flap failure as assessed by physical examinationFrom intraoperative moment to one week postoperatively
Flap perfusion index as assessed by IC-CALC software (Pulsion Medical System)Intraoperatively
Flap length (centimeters)Intraoperatively
Breast-Q questionnaire (postoperative reconstruction module) to measure patient postoperative statusA postoperative test one year after surgery
Number of participants with wound healing delay as assessed by physical examinationFrom two weeks postoperatively to two months postoperatively
Number of participants with reoperationFrom immediate postoperative moment to one year postoperatively
Flap weight (grams)Intraoperatively
Breast-Q questionnaire (preoperative reconstruction module) to measure patient preoperative statusA preoperative test in the last week before surgery

Trial Locations

Locations (1)

La Paz University Hospital

🇪🇸

Madrid, Spain

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