Evidence map›Paper›PMID 39507312›Full record

ArticlePlastic and reconstructive surgery. Global open2024

Diluted Indocyanine Green Angiography: A Novel Approach to Free Flap Perfusion Evaluation in Reconstructive Microsurgery.

Parintosa Atmodiwirjo, Mohamad Rachadian Ramadan, Aditya Wicaksana, Michael Djohan, Nadira Fildza Amanda, Nadhira Anindita Ralena, Ismail Hadisoebroto Dilogo, Purnomo Sidi Priambodo, Retno Asti Werdhani, Em Yunir and 5 more

Abstract read
In one paragraph

Article in Plastic and reconstructive surgery. Global open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Intraoperative imaging during head and neck reconstruction.Current opinion in otolaryngology & head and neck surgery · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Parintosa AtmodiwirjoFrom the Reconstructive Microsurgery and Oncoplasty Section, Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Mohamad Rachadian RamadanFrom the Reconstructive Microsurgery and Oncoplasty Section, Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Aditya WicaksanaFrom the Reconstructive Microsurgery and Oncoplasty Section, Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Michael DjohanFrom the Reconstructive Microsurgery and Oncoplasty Section, Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Nadira Fildza AmandaFrom the Reconstructive Microsurgery and Oncoplasty Section, Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Nadhira Anindita RalenaFrom the Reconstructive Microsurgery and Oncoplasty Section, Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Ismail Hadisoebroto DilogoDoctoral Program in Medical Sciences, Department of Orthopedic and Traumatology, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Purnomo Sidi PriambodoDepartment of Electrical Engineering, Faculty of Engineering, Universitas Indonesia, Depok, Indonesia.
Retno Asti WerdhaniDepartment of Community Medicine, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Em YunirDivision of Endocrinology, Metabolic Disease, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Lisnawati RachmadiDepartment of Pathological Anatomy, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Alida Roswita HarahapDepartment of Clinical Pathology, Dr. Cipto Mangunkusumo National Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Prasandhya Astagiri YusufDepartment of Medical Physiology and Biophysics/Medical Technology IMERI, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Lisa HasibuanDepartment of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia.
Daisuke MitoTrauma and Reconstruction Center, Teikyo University Hospital, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Assessing perfusion in free flaps is crucial in clinical practice. Indocyanine green (ICG) angiography offers a more objective and reproducible method, utilizing near-infrared imaging to monitor flap vascularization. This study aims to evaluate the efficacy of diluted ICG as a tool for assessing free flap perfusion. Methods: This pilot randomized clinical trial compares the fluorescence concentrations of ICG at 3 different dilutions: 5 mg/mL (standard concentration), 2.5 mg/mL (half the standard concentration), and 0.5 mg/mL (one-tenth of the standard concentration). Inclusion criteria required participants to have serum albumin levels above 3 g/dL, hemoglobin levels over 10 g/dL, and no comorbidities. Participants were randomized into 3 groups based on ICG concentration. Fluorescence analysis was performed using ImageJ software to determine mean gray values. Both surgeons and data analysts were blinded to the ICG concentrations administered, ensuring unbiased evaluation. Results: Forty-five patients undergoing free flap surgery, predominantly male (60%) with a mean age of 37.76 ± 19.79 years and a mean body mass index of 21.23 ± 4.49 kg/m², primarily received osteoseptocutaneous fibular free flaps (46.67%), with an average skin flap area of 66.07 ± 46.94 cm². The primary etiology was underlying tumors (84.4%), with the head and neck as the most common reconstruction site (82.2%). The superior thyroid artery was the most frequently used recipient vessel (37.78%). Analysis revealed mean gray values of 64.10 ± 8.27 (5 mg/mL), 79.03 ± 2.7 (2.5 mg/mL), and 33.56 ± 3.47 (0.5 mg/mL), with 2.5 mg/mL yielding the highest value ( Conclusions: Findings suggest using 2.5 mg/mL concentration enhances fluorescence emission, offering a dosage alternative in clinical practice.

Identifiers

PMID39507312
PMCPMC11537560

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.