World J Surg Surg Res | Volume 4, Issue 1 | Case Series | Open Access

How to Secure Pedicled Flaps Using Perioperative Indocyanine Green Angiography: A Prospective Study about 10 Cases

Yanis Berkane1*, Camille Mocquard1,2,3, Sylvie Aillet1, Éric Watier1, Nicolas Bertheuil1,2,3 and Tiphaine Menez1

1Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, France
2INSERM U1236, University of Rennes 1, Rennes, France
3SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital, Rennes, France

*Correspondance to: Yanis Berkane 

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Background: The aim of this study is to report our experience in the evaluation of the intraoperative
use of indocyanine green angiography to secure pedicled flaps.
Methods: We used an intraoperative indocyanine green angiography to assess the perfusion of
ten pedicled flaps performed between January 2021 and March 2021. After harvesting the flap, a
clinical evaluation of its color was made and complemented by intravenous injection of indocyanine
green. The flap’s perfusion was precisely evaluated using a near-infrared camera and, if needed, the
surgeon could reduce the size of the skin paddle, position the flap differently or make any change
aiming at improving perfusion.
Results: Nine patients who underwent reconstructive surgery using pedicled flaps (n=10) between
the 6th of January and the 24th of February 2021 in the Department of Plastic and Reconstructive
Surgery of Rennes’s University Hospital were prospectively included. Intraoperative analysis of the
flap’s perfusion allowed confirmation of a satisfactory clinical aspect in two cases, complementary
actions due to an overall lack of perfusion in five cases and modification or removal of the skin paddle
in four cases. There was no complication secondary to the intravenous injection of indocyanine
Conclusion: Indocyanine green can prove extremely useful to the surgeon during the harvesting of
pedicled flaps and should be widely used to reduce the vascular complications of these flaps.


Indocyanine green; Intraoperative angiography; Flap; Pedicled flap; Reconstructive surgery


Berkane Y, Mocquard C, Aillet S, Watier É, Bertheuil N, Menez T. How to Secure Pedicled Flaps Using Perioperative Indocyanine Green Angiography: A Prospective Study about 10 Cases. World J Surg Surgical Res. 2021; 4:1319..

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