Predicting Nipple Necrosis with a “Lights-on” Indocyanine Green Imaging System: A Report of Two Patients

 

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Abstract

Nipple–areolar complex (NAC) necrosis is a devastating complication in nipple-sparing mastectomies (NSMs) that significantly impacts patient's quality of life. The use of fluorescence angiography for intraoperative assessment of mastectomy skin flap perfusion in NSM has been successfully described and can be utilized to help guide surgical decision-making. Recently, a novel fluorescence-guided surgical imager was developed, OnLume Avata System (OnLume Surgical, Madison, WI), which provides intraoperative evaluation of vascular perfusion in ambient light. In this case report, we describe the use of OnLume fluorescence-guided surgery technology to help aid in clinical decision-making for two breast reconstruction cases with concern for intraoperative nipple hypoperfusion.

Authors' Contributions

Conceptualization: E.C.S., S.J., C.L., S.O.P.

Funding acquisition: A.U.

Methodology: E.C.S., S.J., S.P.M., S.O.P.

Writing - original draft: E.C.S.

Writing - review & editing: E.C.S., S.P.M., S.J., T.S., T.K., A.U., C.L., S.O.P.

Ethical Approval

IRB approval and subject consent was obtained prior to patient data collection (ID: 2020-0906).

Patient Consent

Informed consent was obtained from both patients to utilize clinical photos and information for this manuscript.

Publication History

Received: 09 May 2023

Accepted: 23 October 2023

Article published online:
04 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
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