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Intraoperative Indocyanine Green Fluorescence Angiography Is Sensitive for Predicting Postoperative Wound
Benjamin K Wilke1, Douglas S Schultz, Maria T Huayllani
1From the Department of Orthopedic Surgery (Wilke, Schultz, Sherman, Murray, Forte), the Division of Plastic Surgery (Huayllani, Boczar, Forte), and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL (Huayllani, Boczar, Spaulding, Forte).
Introduction:
Indocyanine green (ICG) angiography is a novel technology that has been predictive of postoperative wound complications. It is unknown whether this technology can successfully predict complications after sarcoma resection. In this study, we aimed to evaluate the sensitivity and specificity of ICG angiography in predicting postoperative wound complications after soft-tissue sarcoma resection.
Methods:
A prospective cohort study of 23 patients was performed beginning October 2017 at our institution. Patients who underwent soft-tissue sarcoma resection were included. After tumor resection and wound closure, evaluation of tissue perfusion in skin edges was performed with ICG angiography. Wound complications were recorded in the postoperative follow-up.
Results:
Eight patients developed postoperative wound complications. Six patients were predicted to have wound complications on the final ICG scans. The accuracy of ICG angiography was dependent on the anatomic location, with improved accuracy in the lower extremity. ICG angiography had a sensitivity of 50%, a specificity and a positive predictive value of 100%, and a negative predictive value of 70% for wound complications after soft-tissue sarcoma resections located in the lower extremity.
Conclusion:
ICG angiography has a high predictive value in the lower extremity for postoperative wound complications.
Level Of Evidence:
Level III, Diagnostic.
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