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Vaccum drainage system application in the management of operation-related non-regional epidural hematoma
Authors:Ma  Jun  Li  Huan  Cheng  Linggang  Lin  Song
Affiliation:1. Stanford Hospital and Clinics, Palo Alto, CA, USA
2. Peoria Surgical Group, Peoria, IL, USA
3. University of Washington Medical Center, Seattle, WA, USA
4. Cleveland Clinic Florida, Westin, FL, USA
5. Stony Brook Medical Center, Stony Brook, NY, USA
6. Johns Hopkins School of Medicine, Baltimore, MD, USA
7. Plastic and Reconstructive Surgery, Duke University Medical Center, Durham, NC, USA
Abstract:Inadequate tissue perfusion is a key contributor to early complications following reconstructive procedures. Accurate and reliable intraoperative evaluation of tissue perfusion is critical to reduce complications and improve clinical outcomes. Clinical judgment is the most commonly used method for evaluating blood supply, but when used alone, is not always completely reliable. A variety of other methodologies have been evaluated, including Doppler devices, tissue oximetry, and fluorescein, among others. However, none have achieved widespread acceptance. Recently, intraoperative laser angiography using indocyanine green was introduced to reconstructive surgery. This vascular imaging technology provides real-time assessment of tissue perfusion that correlates with clinical outcomes and can be used to guide surgical decision making. Although this technology has been used for decades in other areas, surgeons may not be aware of its utility for perfusion assessment in reconstructive surgery. A group of experts with extensive experience with intraoperative laser angiography convened to identify key issues in perfusion assessment, review available methodologies, and produce initial recommendations for the use of this technology in reconstructive procedures.
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