Bone flap perfusion assessment using near-infrared fluorescence imaging

Area of Science:

• Surgical Innovation
• Medical Imaging
• Reconstructive Surgery

Background:

• Microsurgical vascularized bone flaps are crucial for large bone defect reconstruction.
• Assessing bone flap perfusion intraoperatively and postoperatively remains a significant clinical challenge.
• Developing reliable perfusion assessment techniques is vital for improving surgical outcomes.

Purpose of the Study:

• To investigate the efficacy of near-infrared (NIR) fluorescence imaging for assessing vascularized bone flap perfusion.
• To evaluate NIR imaging as a real-time, intraoperative tool for perfusion evaluation.

Main Methods:

• Vascularized bone flaps were created in Yorkshire pigs (n=16).
• Near-infrared (NIR) fluorescence imaging using indocyanine green was performed during flap harvest.
• Perfusion was assessed using clinical observation, Doppler ultrasonography, and NIR imaging, with vascular pedicle clamping for validation.

Main Results:

• NIR fluorescence imaging accurately identified bone perfusion at the osteotomy site.
• NIR imaging showed no fluorescence upon vascular pedicle clamping and fluorescence upon release.
• NIR findings demonstrated 100% agreement with clinical observation and Doppler ultrasonography.

Conclusions:

• Near-infrared (NIR) fluorescence imaging offers a reliable method for real-time, intraoperative assessment of bone flap perfusion.
• This technique holds promise for enhancing the success of reconstructive surgeries involving vascularized bone transfers.