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- W4233078312 abstract "Sir: The Photodynamic Eye (Pulsion Medical Systems, Munich, Germany) device allows a qualitative angiographic evaluation of the vascularization of the flaps. It can display where the indocyanine green fluorescence ends, so it helped us to determine the limit between well-perfused tissue (bright areas) and poorly perfused tissue (dark areas). A threshold fluorescence intensity value for tissue excision was not set because the Photodynamic Eye does not allow a quantitative determination in vivo. As mentioned in the article,1 such calculations were performed in silico. We did not study whether, apart from the operator’s judgment, the injection site, heart rate, blood-pressure, or other factors influenced the time before reaching the highest intensity. We discarded any tissue beyond the bright areas, which in fact produced a fat necrosis incidence of 8.3 percent. Therefore, we cannot recommend excising outside the bright zone. We agree that we observed a high incidence of fat necrosis in our control group. A systematic review found that only a few articles gave a definition of fat necrosis and that there was a high incidence dispersion among different studies.2 Therefore, the reported incidence of this complication might be biased. As we discussed in our study, most of our fat necrosis cases corresponded to grade I of the Lie classification and were managed conservatively.3 We focused on prospectively assessing even small fat necrosis nodules, so we explored the reconstructed breasts between the third and fifth postoperative weeks. We do not know whether published retrospective reports include all small lesions that did not require surgical revision; we could only report all of our observations. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication." @default.
- W4233078312 created "2022-05-12" @default.
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- W4233078312 date "2020-08-26" @default.
- W4233078312 modified "2023-09-25" @default.
- W4233078312 title "Reply: Outcomes of DIEP Flap and Fluorescent Angiography: A Randomized Controlled Clinical Trial" @default.
- W4233078312 cites W2037430216 @default.
- W4233078312 cites W4233169023 @default.
- W4233078312 doi "https://doi.org/10.1097/prs.0000000000007298" @default.
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