ReviewBJS open2018
Systematic review of methodologies used to assess mastectomy flap viability.
Review in BJS open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Updated findings of skin flap thickness and residual breast tissue after mastectomy for breast cancer: a systematic review of the literature.Updates in surgery · 2024Pooled it
- Indocyanine green angiography for preventing postoperative mastectomy skin flap necrosis in immediate breast reconstruction.The Cochrane database of systematic reviews · 2020Pooled it
- Indocyanine Green Angiography Reduces Ischemic Complications in Immediate Implant-Based Breast Reconstruction: A Systematic Review and Meta-analysis.Aesthetic plastic surgery · 2026Article
- Perioperative diffuse optical imaging of blood flow distributions for porcine skin flap viability assessment.Journal of biomedical optics · 2026Article
- Differential effects of phenylephrine on brain versus skeletal muscle microvascular perfusion: an in vivo laboratory study using translational rodent models.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2026Article
- Perioperative diffuse optical imaging of blood flow distributions for porcine skin flap viability assessment.medRxiv : the preprint server for health sciences · 2026Article
- Feasibility and Safety of Using Perforators Through Tendinous Intersections of the Rectus Abdominis for DIEP Flap Breast Reconstruction: A Retrospective Study.Aesthetic plastic surgery · 2026Article
- Tissue perfusion and its influencing factors in epigastrial adipocutanous flaps affected by ischemia-reperfusion in rats.Acta cirurgica brasileira · 2026Article
- Noncontact diffuse optical imaging of blood flow and oxygenation distributions in reconstructive rat skin flaps.Biomedical optics express · 2025Article
- Efficacy of indocyanine green fluorescence-based near-infrared angiography in assessing intraoperative wound perfusion for bone and soft-tissue surgery.Bone & joint open · 2025Article
- Indocyanine Green Angiography to Predict Complications in Subcutaneous Mastectomy: A Single-Center Experience.Journal of personalized medicine · 2025Article
- Factors Affecting Implant Salvage in Patients with Complications After Post-Mastectomy Implant-Based Reconstruction.Journal of clinical medicine · 2025Article
- The Utility of Indocyanine Green Near-Infrared Fluoroangiographyin Assessing Mastectomy Skin Flap Perfusion.Journal of clinical medicine · 2024Article
- The Utility of Indocyanine Green Angiography in Breast Reconstruction to Detect Mastectomy Skin Flap Necrosis and Free Flap Perfusion: An Umbrella Review.Bioengineering (Basel, Switzerland) · 2024Review
- Mastectomy Skin Flap Perfusion Assessment Prior to Breast Reconstruction: A Narrative Review.Journal of personalized medicine · 2024Review
- Intraoperative Near-infrared Spectroscopy Can Predict Skin Flap Necrosis.Plastic and reconstructive surgery. Global open · 2024Article
- Evolution of Indocyanine Green Fluorescence in Breast and Axilla Surgery: An Australasian Experience.Life (Basel, Switzerland) · 2024Review
- Prepectoral Versus Subpectoral Direct-to-Implant Breast Reconstruction: Evaluation of Patient's Quality of Life and Satisfaction with BREAST-Q.Aesthetic plastic surgery · 2023Article
- "Hook Shape" Nipple-Sparing Mastectomy and Prepectoral Implant Reconstruction: Technique, Results and Outcomes from a Preliminary Case Series.Aesthetic plastic surgery · 2023Article
- An animal experiment study on the application of indocyanine green angiography in the harvest of multi-angiosome perforator flap.Annals of translational medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccurate prediction of mastectomy skin flap viability is vital as necrosis causes significant morbidity, potentially compromising results and delaying oncological management. Traditionally assessed by clinical judgement, a more objective evaluation can be provided using intraoperative imaging modalities. This systematic review aimed to compare all intraoperative techniques for assessment of mastectomy flap viability.
methodsA systematic literature review was performed using MEDLINE and Embase databases. Primary outcomes reported included specificity, sensitivity and predictive values of each test, and mean rates of mastectomy flap necrosis and reoperation. Secondary outcomes included cost analysis.
resultsSome 18 studies were included. Designs were prospective cohort study (8), retrospective case series (4), prospective case series (3), retrospective case-control study (1), prospective pilot trial (1) and cost analysis study (1). The studies compared indocyanine green angiography (ICGA) (16 studies) and fluorescein dye angiography (FA) (3 studies) with clinical judgement. Sensitivity and specificity were highest for ICGA (5 studies) ranging from 38 to 100 and 68 to 91 per cent respectively. Both methods overpredicted necrosis. Mean rates of flap necrosis and reoperation decreased with ICGA (7·9 and 5·5 per cent respectively) and FA (3 and 0 per cent) compared with clinical judgement (19·4 and 12·9 per cent). Two studies were designed to define numerical parameters corresponding to perfusion using intraoperative techniques. Two studies performed a cost analysis for ICGA; one claimed a cost benefit and the other advocated its use in high-risk patients only.
conclusionICGA and FA are potentially useful tools for mastectomy flap assessment. However, the predictive accuracy is subject to the specific settings and model of equipment used. Current recommendations support their use in high-risk patients.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.