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Using indocyanine green angiography to achieve complete engraftment of pectoralis major myocutaneous flaps

  • T. Eguchi
    Correspondence
    Correspondence to: Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, 2-3-1 Tsurumi, Tsurumi-ku, Yokohama 230–8501, Japan. Fax: +81 45 580 8327.
    Affiliations
    Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
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  • K Kawaguchi
    Affiliations
    Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
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  • K Sato
    Affiliations
    Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
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  • Y Hamada
    Affiliations
    Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama, Japan
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Published:October 12, 2022DOI:https://doi.org/10.1016/j.ijom.2022.09.036

      Abstract

      Although the pectoralis major myocutaneous (PMMC) flap is among the useful reconstructive materials following oral cancer ablation, this flap has an unstable blood circulation that could result in partial necrosis of the skin paddle. This report describes the usefulness of indocyanine green angiography (ICGA) to achieve complete engraftment of the PMMC flap. Five patients with oral cancer underwent reconstruction with a PMMC flap after cancer ablation. During the skin paddle design and flap elevation, the blood supply to the flap was assessed by ICGA. Areas of the skin paddle that showed no ICG fluorescence were excised. Consequently, prior to transfer to the recipient site, the blood supply to all flaps was confirmed with indocyanine green visible at the edge of the skin paddle, and complete engraftment was achieved without partial necrosis. Based on the results observed, ICGA would make a useful contribution to complete engraftment of the PMMC flap.

      Keywords

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      References

        • Jena A.
        • Patnayak R.
        • Sharan R.
        • Reddy S.K.
        • Manilal B.
        • Rao L.M.C.
        Outcomes of pectoralis major myocutaneous flap in female patients for oral cavity defect reconstruction.
        J Oral Maxillofac Surg. 2014; 72: 222-231https://doi.org/10.1016/j.joms.2013.06.205
        • Ord R.A.
        The pectoralis major myocutaneous flap in oral and maxillofacial reconstruction: a retrospective analysis of 50 cases.
        J Oral Maxillofac Surg. 1996; 54: 1292-1295https://doi.org/10.1016/S0278-2391(96)90484-X
        • Jing Z.
        • Ou S.
        • Ban Y.
        • Tong Z.
        • Wang Y.
        Intraoperative assessment of anterior circulation aneurysms using the indocyanine green video angiography technique.
        J Clin Neurosci. 2010; 17: 26-28https://doi.org/10.1016/j.jocn.2009.03.034
        • Rikimaru H.
        • Kiyokawa K.
        • Inoue Y.
        • Tai Y.
        Three-dimensional anatomical vascular distribution in the pectoralis major myocutaneous flap.
        Plast Reconstr Surg. 2005; 115: 1342-1352https://doi.org/10.1097/01.prs.0000156972.66044.5c
        • Po-Wing Yuen A.
        Preservation of lateral thoracic artery to improve vascular supply of distal skin without compromising pedicle length in harvesting pectoralis major myocutaneous flap.
        J Plast Reconstr Aesthet Surg. 2006; 59: 1433-1435https://doi.org/10.1016/j.bjps.2006.02.007
        • Lyu X.
        • Liu S.
        • Zheng L.
        • Huang M.
        • Zhang J.
        • Zhang J.
        A modified design of the pectoralis major myocutaneous flap for reconstruction of head and neck defect.
        J Craniofac Surg. 2021; 32: 1762-1764https://doi.org/10.1097/SCS.0000000000007287
        • Makiguchi T.
        • Yokoo S.
        • Miyazaki H.
        • Takayama Y.
        • Ogawa M.
        • Hashikawa K.
        • Terashi H.
        Supercharged pectoralis major musculocutaneous flap.
        J Craniofac Surg. 2013; 24: e179-e182https://doi.org/10.1097/SCS.0b013e3182801898