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Laser angiography as a predictor of mastectomy flap necrosis after breast reconstruction.

MethodS: All mastectomy flaps in patients undergoing immediate breast reconstruction over a a two year period were studied. The vascularity of each flap was assessed clinically and simultaneous intraoperative images were obtained using infrared fluorescent tissue angiography (Novadaq SPY SP2001, Mississauga, Ontario) with ICG (Akorn, Buffalo Grove, IL). Postoperatively, the amount of fluorescence (fluorescence level (FL)) throughout each image was calculated (SPY-Q, Novadaq), with relative percentages of fluorescent brightness noted when compared to the most well perfused area of each respective flap (or brightest, regarded as 100%). The fluorescent images and respective postoperative photographs were then compared and areas of ischemic necrosis were correlated.