Mastectomy Skin Flap Perfusion Assessment Prior to Breast Reconstruction: A Narrative Review

Abstract

Background: Predicting the viability of the skin flaps after mastectomy is of high importance and significance in immediate breast reconstruction. Numerous methods have been used and are readily available. This review aims to describe and compare the current preferred perfusion assessment tools. Methods: Four major scientific databases—Web of Science, PubMed, Embase, and Scopus—were consulted to retrieve reviews, meta-analyses, clinical trials, experimental studies, and case reports focused on skin flap perfusion assessment following mastectomy. English-language articles published within the last 10 years were included. The most recent search was conducted on 31 July 2024. Results: A summary focused on the relevant information of all included studies was drafted, and the results of the studies have been synthetized and compared. A total of 58 studies have been included in this review. Conclusion: Indocyanine green angiography (ICG-A) is the preferred and most-used method of evaluating perfusion, especially in high-risk patients, while new technologies show promising results and might be of great interest in the future. Perfusion assessment tools complement and should not replace clinical evaluation.