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Review
. 2018;41(3):269-278.
doi: 10.1007/s00238-018-1404-5. Epub 2018 Feb 27.

Near-infrared fluorescence image-guidance in plastic surgery: A systematic review

Anouk J M Cornelissen  1 , Tom J M van Mulken  1 , Caitlin Graupner  1 , Shan S Qiu  1 , Xavier H A Keuter  1 , René R W J van der Hulst  1   2 , Rutger M Schols  1
Affiliations
Review

Near-infrared fluorescence image-guidance in plastic surgery: A systematic review

Anouk J M Cornelissen et al. Eur J Plast Surg. 2018.

Abstract

Background: Near-infrared fluorescence (NIRF) imaging technique, after administration of contrast agents with fluorescent characteristics in the near-infrared (700-900 nm) range, is considered to possess great potential for the future of plastic surgery, given its capacity for perioperative, real-time anatomical guidance and identification. This study aimed to provide a comprehensive literature review concerning current and potential future applications of NIRF imaging in plastic surgery, thereby guiding future research.

Methods: A systematic literature search was performed in databases of Cochrane Library CENTRAL, MEDLINE, and EMBASE (last search Oct 2017) regarding NIRF imaging in plastic surgery. Identified articles were screened and checked for eligibility by two authors independently.

Results: Forty-eight selected studies included 1166 animal/human subjects in total. NIRF imaging was described for a variety of (pre)clinical applications in plastic surgery. Thirty-two articles used NIRF angiography, i.e., vascular imaging after intravenous dye administration. Ten articles reported on NIRF lymphography after subcutaneous dye administration. Although currently most applied, general protocols for dosage and timing of dye administration for NIRF angiography and lymphography are still lacking. Three articles applied NIRF to detect nerve injury, and another three studies described other novel applications in plastic surgery.

Conclusions: Future standard implementation of novel intraoperative optical techniques, such as NIRF imaging, could significantly contribute to perioperative anatomy guidance and facilitate critical decision-making in plastic surgical procedures. Further investigation (i.e., large multicenter randomized controlled trials) is mandatory to establish the true value of this innovative surgical imaging technique in standard clinical practice and to aid in forming consensus on protocols for general use.Level of Evidence: Not ratable.

Keywords: Anatomical navigation; Image-guided surgery; Microsurgery; Near-infrared fluorescence imaging; Plastic surgery; Reconstructive surgery; Tissue perfusion assessment.

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Conflict of interest statement

Compliance with ethical standardsAnouk J.M. Cornelissen, Tom J.M. van Mulken, Caitlin Graupner, Shan S. Qiu, Xavier H.A. Keuter, René R.W.J. van der Hulst and Rutger M. Schols declare that they have no conflict of interest.None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.Not applicable for this article type.

Figures

Fig. 1
Fig. 1
Flow diagram of the literature search according to PRISMA statement
See this image and copyright information in PMC

References

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