The Utility of Indocyanine Green Near-Infrared Fluoroangiographyin Assessing Mastectomy Skin Flap Perfusion

Background: Breast reconstruction with implants is now the preferred procedure following mastectomies. For successful reconstruction, accurate evaluation of the patient and skin flap viability is essential. This study aimed to analyze the impact of risk factors on mastectomy skin flap necrosis (MSFN) and the effectiveness of indocyanine green angiography (ICGA) in preventing complications. Methods: Fifty consecutive patients undergoing mastectomy were divided into two groups (arms A and B) based on the method of skin flap evaluation (ICGA vs. clinical assessment, respectively). Demographic details and the risk factor incidence were collected, and complication rates were compared between the two groups. Univariate analysis was conducted to identify correlations between mastectomy skin flap necrosis and the aforementioned risk factors. Results: The two groups showed comparable demographics and incidences of risk factors. Patients in arm A exhibited a lower rate of complications and reinterventions, although no significant differences were observed. Statistical analysis revealed a significant association between BMI, implant volume, and MSFN. Conclusions: ICGA proves to be an effective diagnostic tool for assessing skin flap viability. When coupled with meticulous patient selection, it aids in preventing complications.