Table 2. Methods for evaluation of tissue perfusion.

Method/setting	Use	Advantages	Limitations	Sources
ICG intraoperative perfusion assessment	Visualize perforator perfusion zone in real time	Visualizes perforator perfusion zones	Requires administration of contrast media	Phillips et al., 2012 (10); Francisco et al., 2010 (11); Komorowska-Timek & Gurtner, 2010 (1); Murray et al., 2010 (12); Tamburrino et al., 2010 (13); Newman et al., 2013 (14); Jones et al., 2009 (15); Holm et al., 2002 (16); Holm et al., 2002 (17); Still et al. 1999 (18)
	Confirm patency of arterial and venous anastomoses	No exposure to ionizing radiation	Does not identify precise vessel location or course through muscle and fascia
	Confirm perfusion of tissue prior to incision, after elevation of flaps, and prior to final closure	Strong safety profile and short half-life of ICG
		Permits re-evaluation during same surgery
Fluorescein	Visualization of perforator perfusion zone	Visualization of perforator perfusion zone	Single use only	Phillips et al., 2011 (10); Losken et al., 2008 (19)
		Widely available	No venous information
			Long delay time
			Toxicity concerns
			Use of ultraviolet Woods lamp
Clinical judgment	Estimation of tissue perfusion and flap viability	Familiarity, ease of use	Poor reliability when used alone	Phillips et al., 2011 (10); Holm et al., 2002 (16)
			Dependent on surgeon experience
			Inferior to imaging modalities for estimation of flap survival

ICG, indocyanine green.