Prediction of skin viability following en bloc resection for osteogenic sarcoma with fluorescein

Intravenous fluorescein dye was applied as a test of skin viability in 11 en bloc resections for osteogenic sarcoma about the knee. Intravenous fluorescein dye is an easy, safe, efficient, and inexpensive method that helps to predict the viability of surgically created skin flaps. When patchy fluorescence is observed, primary debridement is recommended to prevent immediately postoperative skin necrosis. This test proved to be an accurate, significant indicator of nonviable skin, in both location and dimension. All flaps that were patchy by the fluorescein test consisted of nonviable skin. Conversely, flaps that took up the dye evenly went on to uneventful wound healing. The fluorescein test should be considered for further application in orthopedic surgical procedures when skin viability is uncertain, e.g., in cases of trauma and complicated reconstructions about the knee and elbow.