MedPath

ICG Indocyanine Green in Reconstructive Surgery

Conditions
Surgery
Fluorescence
Interventions
Registration Number
NCT06129669
Lead Sponsor
Amsterdam UMC, location VUmc
Brief Summary

The success or failure of a reconstruction is largely related to the vascularization of the operated area. Near infrared fluorescence (also near infrared fluorescence angiography, NIR FA) with ICG administration is an innovative technique to quantify tissue perfusion. Based on the results obtained in other subspecialties, NIR fluorescence appears to be a promising way to quantify tissue perfusion in reconstructive surgery. Fluorescence research has previously been used in the context of microsurgery and breast reconstructions using implants, but structural objective determinations are lacking. Our study is successful if we are able to determine a cut off value for the absolute or relative perfusion parameters.

Detailed Description

Not available

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
160
Inclusion Criteria
  • Aged 18 or older
  • Undergoing debridement and/or reconstructive surgery included in the aforementioned groups
Exclusion Criteria
  • allergy or hypersensitivity to sodium iodide, iodine, ICG or shellfish
  • patients with hyperthyroidism and patients with autonomic thyroid adenoma
  • pregnancy or lactation
  • epilepsy
  • severe liver failure
  • renal failure with a GFR <60.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Debridement after radiotherapyIndocyanine greenDebridement after radiotherapy
Debridement after traumaIndocyanine greenDebridement after trauma
Reconstructive surgery using a fasciocutaneous flapIndocyanine greenReconstructive surgery using a fasciocutaneous flap
Reconstructive surgery using a muscle flapIndocyanine greenReconstructive surgery using a muscle flap
Reconstructive surgery using a osseous flapIndocyanine greenReconstructive surgery using a osseous flap
PhalloplastiesIndocyanine greenPhalloplasties
VaginaplastiesIndocyanine greenVaginaplasties using a peritoneum flap or colon interposition
Finger replantationIndocyanine greenFinger replantation
Primary Outcome Measures
NameTimeMethod
Relative PerfusionOnce during the surgery

Maximum perfusion intensity (Imax, units) in a normal vascularized reference frame / Maximum perfusion intensity (Imax, units) in a normal vascularized reference frame

Maximum perfusion intensity (ROI)Once during the surgery

2. Maximum perfusion intensity (Imax, units) in a normal vascularized reference frame

Maximum perfusion intensity (Normal)Once during the surgery

1. Maximum perfusion intensity (Imax, units) in a normal vascularized reference frame

Secondary Outcome Measures
NameTimeMethod
IngressOnce during the surgery

Rate of increase in intensity from baseline to peak intensity (Ingress, units)

EgressOnce during the surgery

Degree of decrease in intensity from peak to last measurement (Egress, units)

TmaxOnce during the surgery

Time to reach maximum perfusion in region of interest (Tmax, sec)

Wound infectionFollow up at six weeks postoperative

Defined as none, local wound treatment, antibiotics, or hospitalization.

Delayed unionFollow up at six and twelve months postoperative

Radiologic examination (Xray or CT) concluding on the presence of delayed union after 6 months or non-union after 12 months

Lap FailureFollow up at six weeks postoperative

Quantified as I \<5%; II 5-15%, III 15-50%, IV\> 50%, V complete

Skin necrosisFollow up at six weeks postoperative

Defined as none, partial thickness, and full thickness.

Relative Perfusion before and after tissue transferTwice during the surgery

Maximum perfusion intensity (Imax, units) in the same reference frame after tissue transfer / Maximum perfusion intensity (Imax, units) in a reference frame before tissue transfer

Trial Locations

Locations (1)

Amsterdam UMC

🇳🇱

Amsterdam, Netherlands

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