Abstract
Microsurgical restoration of avulsed facial tissue is technically challenging because of the small vessel size and complex anatomy. In trauma cases, accurate identification of ischemic zones is essential for achieving successful outcomes. We report a successful case of microvascular restoration in degloving-type nasal trauma, assisted with indocyanine green angiography for ischemic zone identification. A 56-year-old man sustained a devascularized nasal avulsion following an escalator injury. Microsurgical exploration guided by indocyanine green angiography revealed compromised perfusion in the left lateral nasal region. Focused microvascular repair of the left lateral nasal artery led to immediate perfusion improvement and complete nasal tissue survival. Intraoperative indocyanine green angiography enabled precise identification of ischemia, minimized unnecessary dissection, and improved efficiency, thereby allowing greater emphasis on the aesthetic and functional restoration of the nose. Real-time indocyanine green angiography may enhance decision-making and improve outcomes in nasal avulsion injuries. Broader adoption of indocyanine green may enhance both efficiency and outcomes in facial trauma surgery.