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Ma et al. Plast Aesthet Res 2021;8:32 Plastic and
DOI: 10.20517/2347-9264.2021.20
Aesthetic Research

Original Article Open Access

Multipoint injection indocyanine green
lymphography can reduce lymphaticovenular

anastomosis surgical time and improve the surgical
results for lymphedema

Gejia Ma, Xin Cui, Yue Han, Wenfei Wang, Bin Liu

Department of Burn and Plastic Surgery, Xi’an Central Hospital, Medical School of Xi’an Jiaotong University, Xi’an 710000,
Shaanxi, China.
Correspondence to: Dr. Gejia Ma, Xi’an Central Hospital, Medical School of Xi’an Jiaotong University, No.185 Houzaimen Road,
Xi’an 710000, Shaanxi, China. E-mail: gejiama@hotmail.com; Dr. Bin Liu, Xi’an Central Hospital, Medical School of Xi’an Jiaotong
University, No.185 Houzaimen Road, Xi’an 710000, Shaanxi, China. E-mail:leorobbins@163.com

How to cite this article: Ma G, Cui X, Han Y, Wang W, Liu B. Multipoint injection indocyanine green lymphography can reduce
lymphaticovenular anastomosis surgical time and improve the surgical results for lymphedema. Plast Aesthet Res 2021;8:32.
https://dx.doi.org/10.20517/2347-9264.2021.20
Received: 6 Mar 2021 First Decision: 25 Apr 2021 Revised: 9 May 2021 Accepted: 9 Jun 2021 Available online: 4 Jul 2021

Academic Editors: Raúl González-García, Matthew L Iorio, Isao Koshima Copy Editor: Yue-Yue Zhang Production Editor: Yue-
Yue Zhang

Abstract
Aim: Lymphaticovenular anastomosis (LVA) is the mainstay of surgical treatment of lymphedema now.
Indocyanine green (ICG) lymphography is a method for detecting lymphatic pathways and for the clinical
evaluation of patients with extremity lymphedema. The essential point of LVA is to find more functional lymphatic
vessels. Sometimes, in cases of lymphatic dysfunction, ICG injections into the distal extremities are insufficient.
The purpose of this study was to elucidate the effect of multi-injection of ICG lymphography on LVA.

Methods: In this study, we injected ICG into the second web of the hands or the first web of the feet. In the multi-
injection group, we injected additional ICG in other sites. We observed the presence or absence of a linear pattern
at each injection site with a near-infrared camera. Then, we performed LVA and evaluated the circumference
change and the operation time.

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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