The green indocyanine: the meaning of one tracer for the intra-peri operative imaging and vascular evaluation in the reconstructive surgery of head and neck: an experimental multidisciplinary study

The objective of this study was to evaluate the feasibility and reproducibility of a new diagnostic approach through the flow injection of green indocyanine such as the intraoperative and perioperative vascularization in the reconstruction of various anatomical areas with pedunculated or microsurgical free flaps, the identification of the sentinel lymph node in the latero cervical emptying or the assessment of the quality of anastomoses in organ transplantation. The study involved ten patients who underwent reconstructive procedures with different surgical approaches for reconstructive surgery of head and neck. An intraoperative check was performed in several stages to assess the real perfusion status of the treated area. Indocyanine green was used in all the patients in association with an intraoperative imaging diagnostic system. Indocyanine green showed in all the cases a full highlight of central and peripheral vascularization. Furthermore, this imaging system allowed a satisfactory and rapid intraoperative evaluation of the vascular tree and a high sensitivity in detection of the sentinel lymph node in latero cervical emptying. Despite the limited sample, the results suggest that the intraoperative administration of indocyanine green may represent a valid evaluating system for reconstructed flap perfusion and for sentinel lymph node identification in oncological surgery