PMC3579431_01
Template of defect and proposed reconstruction.
eplasty13e08_fig1.jpg
PMC3579431_01_eplasty13e08_fig1.jpg
F1
A Doppler probe was used to identify the course of the right supratrochlear vessels (Fig 1).
Transposed forehead flap.
eplasty13e08_fig2.jpg
PMC3579431_01_eplasty13e08_fig2.jpg
F2
The flap was then transposed into the defect and sutured in place with interrupted sutures (Fig 2).
Intraoperative evaluation of forehead flap perfusion after clamping of pedicle and injection of indocyanine green using SPY technology. Fluorescence is demonstrated in transferred flap in spite of pedicle clamping, indicating perfusion to flap. SPY technology subsequently demonstrates continued flap perfusion after division of pedicle and inset of flap.
eplasty13e08_fig3.jpg
PMC3579431_01_eplasty13e08_fig3.jpg
F3
A 10-mg dose of ICG was administered intravenously and images were captured with the SpyElite System (Fig 3). (There is not currently a consensus as to the dose of ICG that should be administered. A second 10-mg dose of ICG was administered intravenously after inset (23 minutes after the first dose was given) to confirm perfusion and flap viability (Fig 3). This is further confirmed by viewing the second image in Fig 3, which demonstrates an increase in fluorescence when compared with the surrounding tissues.