J reconstr Microsurg 2019; 35(07): 471-478
DOI: 10.1055/s-0039-1679958
Invited Review
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Intraoperative Perfusion Assessment in Mastectomy Skin Flaps: How Close are We to Preventing Complications?

1  Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Cecil Qiu
2  Division of Plastic and Reconstructive Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
,
Halley Darrach
1  Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Franca Kraenzlin
1  Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
,
George Kokosis
1  Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Tinglu Han
3  Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, CAMS, PUMC, Beijing, China
,
Justin M. Sacks
1  Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

24 September 2018

19 January 2019

Publication Date:
21 February 2019 (eFirst)

Abstract

Background Mastectomy flap necrosis is the source of considerable morbidity and cost following breast reconstruction. A great deal of effort has been put forth to predicting and even preventing its incidence intraoperatively.

Methods A review of the literature was performed evaluating the evidence of mastectomy skin flap perfusion technologies.

Results Multiple technologies have leveraged spectroscopy and/or angiography to provide real-time assessment of flap perfusion, including indocyanine green, fluorescein, and light-based devices.

Conclusion This manuscript endeavors to review the evidence on mastectomy skin flap perfusion analysis, highlighting the benefits, and downsides of the current technologies and identifying exciting areas of future research and development.