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1 Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. T blood circulation regions of Zone IV and Zone II in the transverse rectus abdominis musculo-cutaneous flap are known to depend on individual patients.1 Conducting the indocyanine green (ICG) test helps ensure the safety of flap surgery; however, there have been reports of anaphylactic shock due to ICG intravenous injection.2,3 Even a single small-dose administration (5 mg) of intravenous ICG can cause anaphylactic shock,4 so its administration to patients with iodine hypersensitivity is contraindicated. We developed a noninvasive method using the fingerstall-type tissue oximetry system Toccare (Astem, Japan) to determine the skin perfusion area.5 Accumulating results indicated the average tissue oxygen saturation (StO2) matching the ICG border to be 41.4%. We applied this result to a clinical patient with iodine hypersensitivity for the first time.

plastic and reconstructive surgery. global open

Determining Transverse Rectus Abdominis Musculo-cutaneous Flap Viability using Fingerstall-type Tissue Oximetry as an Alternative to Indocyanine Green Fluorescence Imaging: A Case of a Patient with Iodine Hypersensitivity