Plastic and Reconstructive Surgery, Global Open (Sep 2014)

Utility of Indocyanine Green Fluorescence Lymphography in Identifying the Source of Persistent Groin Lymphorrhea

  • John S. Maddox, MD,
  • Jennifer M. Sabino, MD,
  • E. Bryan Buckingham, MD,
  • Gerhard S. Mundinger, MD,
  • Jonathan A. Zelken, MD,
  • Rachel O. Bluebond-Langner, MD,
  • Devinder P. Singh, MD,
  • Luther H. Holton, III, MD

DOI
https://doi.org/10.1097/GOX.0000000000000135
Journal volume & issue
Vol. 2, no. 9
p. e210

Abstract

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Summary: Surgical manipulation of the groin can result in lymphatic injury in a significant number of patients leading to poor wound healing or infectious complications. Surgical repair of lymphatic injury is greatly aided by the precise and prompt intraoperative localization of the injured lymphatic vessels. We assessed and identified lymphatic leaks in 2 cases of surgical wound lymphorrhea occurring after instrumentation of the groin using laser-assisted indocyanine green lymphography paired with isosulfan blue injection. Both cases healed without complication, and no lymphatic leak recurrence was observed during postoperative follow-up. Laser-assisted indocyanine green lymphography is a useful adjunct in the management of lymphatic leaks after surgery of the groin and may have potential for prophylactic evaluation of high-risk groin wounds.