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Role of Indocyanine Green to Mitigate Wound Complications in Component Separation Technique for Ventral Hernia Repair—Our Early Experience

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Abstract

Background

The ease of the anterior component separation technique (ACST) makes it an attractive surgical option for ventral hernia repairs (VHR). Incorporation of indocyanine green-fluorescence angiography (ICG-FA) to map soft tissue perfusion during open ACST is an effective way to minimize the wound complications. This study aims to evaluate the impact of adoption of ICG-FA on wound-related complications following open ACST in VHR.

Methods

We performed a retrospective review of patients who underwent VHR with the open ACST at a single centre between March 2018 and July 2020. The study comprised of consecutive cases of open ACST with onlay meshplasty done before (March 2018–April 2019) and after (May 2019 to July 2020) implementation of ICG-FA for intra-operative perfusion mapping of subcutaneous tissue and skin.

Results

The pre-ICG group and post-ICG group were similar in terms of baseline patient demographics and peri-operative details. The rate of surgical site occurrence’s was higher in the pre-ICG group, but this result was not statistically significant (46% vs. 26%; p value 0.189). Skin necrosis, however, was observed in significantly less patients of the post-ICG cohort (29% vs. 5%; p value 0.045).

Conclusion

This study demonstrates the effectiveness of perfusion mapping by the use of ICG angiography to determine potential areas of decreased perfusion and thereby minimize wound complications. Using ICG-FA to guide removal of at-risk tissue to minimize wound complications may substantially improve the patients outcome.

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Funding

There were no sources of funding for the present study.

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Authors and Affiliations

  1. Department of General Surgery, Seth GSMC and KEM Hospital, Mumbai, India

    Jignesh Gandhi, Amay Banker, Sadashiv Chaudhari & Pravin Shinde

Authors
  1. Jignesh Gandhi
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  2. Amay Banker
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  3. Sadashiv Chaudhari
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  4. Pravin Shinde
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Contributions

All authors contributed to the study equally. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Pravin Shinde.

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Conflict of interest

Authors Dr. Amay Banker, Dr. Pravin Shinde, Dr. Jignesh Gandhi and Dr. Sadashiv Chaudhari declare that they have no conflicts of interest.

Ethical approval

The study was approved by the institutional review board and owing to the retrospective nature of our study, waiver of consent was granted. All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments.

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This analysis and manuscript has not been published and is neither under consideration for publication elsewhere.

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Gandhi, J., Banker, A., Chaudhari, S. et al. Role of Indocyanine Green to Mitigate Wound Complications in Component Separation Technique for Ventral Hernia Repair—Our Early Experience. World J Surg 45, 3073–3079 (2021). https://doi.org/10.1007/s00268-021-06210-4

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  • DOI: https://doi.org/10.1007/s00268-021-06210-4

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