1. What data in particular will be shared?
   Response - Individual participant data that underlie the results reported in this article, after de-identification (text, tables, figures, and appendices).
   


2. What additional supporting information will be shared?
   Response -  Study Protocol
   Response -  Statistical Analysis Plan
   Response - Clinical Study Report
   
   
3. Who will be able to view these files?
   Response - Researchers whose proposed use of the data has been approved by an independent review committee identified for this purpose.
   


4. For what types of analyses will this data be available?
   Response - To achieve aims in the approved proposal.
   


5. By what mechanism will data be made available?
   Response - To gain access, data requestors will need to sign a data access agreement. Data are available for 5 years at a third party website (shri.7.dh@gmail.com).
   


6. For how long will this data be available start date provided 31-08-2028 and end date provided 31-08-2031?
   Response - Beginning 9 months and ending 36 months following article publication.
   


7. Any URL or additional information regarding plan/policy for sharing IPD? 
   Additional Information - NIL

Head and neck cancer surgeries often involve removing parts of the face or mouth and reconstructing them using tissue flaps. One commonly used technique in India is the pectoralis major myocutaneous (PMMC) flap, which is reliable and cost-effective. However, poor blood flow in parts of the flap can lead to serious complications such as tissue death, wound breakdown, infection, or the need for repeat surgery. These issues can delay recovery and postpone important treatments like radiotherapy.

Traditionally, surgeons assess flap blood supply during surgery using their clinical judgment—by checking color, bleeding, and temperature. These methods are highly subjective and depend on the surgeon’s experience. As a result, they sometimes fail to detect poorly perfused (low blood flow) areas of the flap.

This study introduces Indocyanine Green Fluorescence Angiography (ICG-A), a modern imaging technique that provides real-time, objective visualization of blood flow. ICG is a dye that, when injected into the bloodstream, fluoresces under infrared light. Using a specialized camera, surgeons can see exactly which areas of the flap have good or poor blood supply. This helps them make more accurate decisions about which tissue to keep and which to revise during the operation.

By comparing traditional methods with ICG-A in a randomized trial, this study aims to evaluate whether ICG-A can reduce complications, improve flap survival, and support faster postoperative recovery, such as earlier feeding, shorter hospital stays, and timely start of radiotherapy.

If successful, this research could help make surgeries safer and more effective, especially in Indian hospitals where PMMC flaps are commonly used, and lead to wider adoption of ICG technology in reconstructive cancer surgery.