Is non-invasive indocyanine-green angiography a useful adjunct for the debridement of infected sternal wounds?

Richard Tyrell, Catherine Kilmartin, Edwin Acevedo, Suresh Keshavamurthy, Andrew Gassman

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Laser-assisted indocyanine-green imaging (ICG) has a wide range of surgical applications, and has been used in reconstructive surgery to aid in assessing the viability of free tissue transfers and to help predict poor tissue perfusion. However, its indications for use is limited to assessing free flap tissue perfusion, coronary artery perfusion during coronary artery bypass (CABG), and tissue perfusion in diabetic foot ulcers, to name a few. This system has been proven to be a safe, reliable adjunctive modality to assess microvascular compromise or poor perfusion peri-operatively, which could minimize skin necrosis and other post-operative complications (Further et al., 2013).1 The ability to objectively assess tissue perfusion has led to improved post-operative outcomes in breast, abdominal wall, colorectal, and cardiac surgery. To date, no studies have reviewed the use of ICG in delineating devitalized bone during sternal wound debridement after cardiac surgery. At our institution, we have encountered a cohort of patients with post-cardiac surgery sternal wound infections who have required debridement of infected and devitalized bone. We propose that SPY technology aids in delineating this devitalized bone, and may aid in the timing muscle flap coverage. In this paper, we will demonstrate two cases of patients who had post-operative sternal wound infections after undergoing cardiac surgery for which ICG was used to demarcate debridement zones and subsequent flap coverage. In these cases, ICG allowed for efficient and reliable intraoperative evaluation of bony perfusion and has aided in early adequate debridement and flap coverage.

Original languageEnglish
Pages (from-to)117-120
Number of pages4
JournalJPRAS Open
StatePublished - Jun 2018

Bibliographical note

Publisher Copyright:
© 2018 The Author(s)


  • Debridement
  • Indocyanine green
  • Spy angiography
  • Sternal wound

ASJC Scopus subject areas

  • Surgery


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