A Study Assessing Circulation Around Surgical Incisions at the Time of Laparotomy Closure

Study Overview
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Brief Summary
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This study is being done to find out if Spectrum Near-Infrared (NIR) imaging with Indocyanine Green (ICG) dye can help measure blood flow around an incision before and after the surgeon closes the incision with staples or sutures. The Spectrum NIR imaging system uses a handheld camera that produces a special type of light that can help surgeons see things during surgery that are difficult to see with the naked eye, for example, cancer tissue versus healthy tissue. Spectrum NIR imaging has been approved by the Food and Drug Administration (FDA) as a tool that is widely used during surgery. ICG dye is a sterile solution that can be seen with Spectrum NIR imaging. This dye, used with Spectrum NIR imaging, allows surgeons to see blood flow to parts of the body during and after surgery. Making sure that there is enough blood flow to the surgical site helps to promote a less complicated recovery.

Official Title
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Feasibility of Assessing Wound Perfusion at the Time of Laparotomy Closure

Conditions
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Laparotomy

Intervention / Treatment
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* Procedure: Laparotomy
* Other: ICG
* Other: Spectrum NIR imaging system


Participation Criteria
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Eligibility Criteria
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Criteria for Eligibility Prior to Surgery Inclusion Criteria: Woman undergoing a laparotomy procedure via a vertical midline incision for any indication with the Gynecology Service at MSK Age ≥18 years Exclusion Criteria: Women with hepatic dysfunction as evidenced by elevated transaminases Women with a history of cirrhosis or other chronic liver disease Women with an allergy to iodine Women undergoing laparoscopic or minimally invasive surgery Criteria for Eligibility Post-Surgery Inclusion Criteria: Woman undergoing a laparotomy procedure via a vertical midline incision for any indication with the Gynecology Service at MSK Age ≥18 years Subject Exclusion Criteria: Women with laparotomy incisions unable to be closed primarily due to tissue or fascial damage Women with transverse laparotomy incisions Women with laparotomy incisions left open due to a case classification as contaminated or dirty

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Twenty consecutive patients will be enrolled: the first 10 will have skin closure with staples, and the second 10 will have skin closure with a running subcuticular suture.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Women having a Laparotomy<br>The first 10 patients enrolled will undergo skin closure with staples. The next 10 patients enrolled will undergo skin closure with a running subcuticular suture.to evaluate skin perfusion using the Spectrum NIR imaging system following intravenous injection of ICG in all patients. Patients will be assigned skin closure with either running subcuticular suture or skin staples in a sequential, nonrandomized fashion before the procedure. After the planned surgical procedure is complete, ICG will be injected intravenously. Video of the incision will be recorded. After skin closure is complete, a second intravenous bolus of ICG (same dose as previously injected) will be given. Video of the incision will again be recorded. Measurement of perfusion will subsequently be performed by video analysis at the previously described three predefined points along the incision after surgery is complete and again after skin closure. | Procedure: Laparotomy<br>* Laparotomy via vertical midline incision and after the planned surgical procedure is complete.<br>Other: ICG<br>* ICG will be injected intravenously ICG is a fluorescent iodide dye.<br>Other: Spectrum NIR imaging system<br>* The Spectrum NIR imaging system uses a handheld camera that emits light in the NIR range.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| percentage of cases with successful perfusion measurements | Feasibility will be determined by the percentage of cases with successful perfusion measurements. | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Laparotomy, Surgical Incisions, Wound Perfusion, 17-650