ICG Fluorescence in Plastic, Reconstructive and Oncologic Surgery: From Flap Perfusion to Lymphedema

In recent years, the use of Indocyanine Green (ICG) fluorescence imaging has witnessed a remarkable surge across plastic, reconstructive, and oncologic surgery, shaping a transformative approach to surgical planning and intraoperative guidance. ICG is a fluorescent dye that, when administered intravenously or intradermally, allows surgeons to visualize blood flow, microvascular perfusion, and lymphatic pathways in real time, thereby enhancing clinical decision-making and surgical precision. This Research Topic is dedicated to exploring the applications, clinical benefits, and technological innovations associated with ICG fluorescence across the reconstructive and oncologic spectrum, spanning from acute flap perfusion assessment to functional lymphatic surgery.The integration of ICG fluorescence angiography and lymphography has opened new avenues for precise tissue evaluation, enabling the real-time assessment of free and pedicled flap perfusion, viability of mastectomy skin flaps, localization of sentinel lymph nodes, and dynamic mapping of lymphatic channels in lymphedema. These applications are crucial in reducing complication rates such as fat necrosis and flap failure, optimizing oncologic margins, facilitating physiologic lymphedema procedures, and improving overall patient outcomes.This Research Topic aims to gather a comprehensive collection of original research articles, reviews, clinical case studies, and technical notes that delve into various uses of ICG in the field. The goal is to provide surgeons with insights into innovative methodologies, potential challenges, and future directions for research and clinical practice with ICG.Key areas of interest include, but are not limited to:• ICG angiography in autologous breast reconstruction, microsurgical flap procedures, and complex wound repair• ICG lymphography for the diagnosis, staging, and surgical execution of lymphedema (LVA, VLNT, and immediate lymphatic reconstruction)• Applications in oncologic surgery: sentinel lymph node biopsy, skin and soft-tissue tumor margin assessment, and occult lesion detection• Comparative studies assessing ICG versus traditional clinical evaluation and alternative perfusion imaging modalities• Innovations in near-infrared camera platforms, quantification algorithms, and standardized intraoperative dosing protocols• Discussion of limitations, false-positive/negative rates, cost-effectiveness, and long-term patient-reported outcomesBy synthesizing a body of work within this topic, our aim is to not only highlight current practices and successes but also to identify gaps in knowledge that future studies may address. Ultimately, the objective is to advance the fields of plastic, reconstructive, and oncologic surgery, encouraging widespread adoption of ICG technology where beneficial, and refining surgical techniques for improved patient care. Topic editors: Federico Tamborini, Federico Lo Torto, Alessia Pagnotta Source: https://www.frontiersin.org/research-topics/72272/icg-fluorescence-in-plastic-reconstructive-and-oncologic-surgery-from-flap-perfusion-to-lymphedema