Contrast-Enhanced Ultrasound Combined with Three-Dimensional Reconstruction in Preoperative Perforator Flap Planning

Su, Weijie; Lu, Linguo; Lazzeri, Davide; Zhang, Yi Xin; Wang, Danru; Innocenti, Marco; Qian, Yunliang; Agostini, Tommaso; Levin, L. Scott; Messmer, Caroline

doi:10.1097/prs.0b013e3182729e9e

Cited by 44 publications

(55 citation statements)

References 32 publications

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“…have been developed to overcome the problem, for example, handheld acoustic Doppler, color duplex ultrasound, contrastenhanced ultrasound, computed tomography angiography, and magnetic resonance angiography. [10][11][12][13][14] However, these tools have their own pros and cons. The handheld Doppler has several advantages in that it is easy to learn, portable, and available at most hospitals.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Mapping of the Subfascial Plexus Using the Transillumination Method for Head and Neck Reconstruction with Free Style Anterolateral Thigh Flaps

Huang¹,

Huang²,

et al. 2018

Facial plast Surg

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Without well recognizing the vascular territories of the perforator, surgery might damage the pedicle and diminish flap survival. This study described a transillumination method for intraoperative mapping of the subfascial plexus of the perforator in the head and neck reconstruction with an anterolateral thigh (ALT) flap and also compared the perioperative outcomes and complications of the method with those of the conventional two-pedicle ALT flap. Between January 2011 and December 2017, 26 patients who underwent head and neck reconstruction with ALT flaps were evaluated as follows: 13 underwent the transillumination method (case group), and 13 (age- and sex-matched) underwent standard two-pedicle flap procedures (control group). Demographic factors, diagnosis, flap size, recipient site, perioperative data, and postoperative complications were compared between the two groups. There was no significant difference in age, sex, diagnosis, recipient sites, and flap size between the case and control groups. Regarding the perioperative outcomes, the harvesting time was significantly shorter in the case group than in the control group (60 vs. 100 minutes, < 0.001). The operative time was shorter in the case group than in the control group, but this difference was not statistically significant (300 vs. 420 minutes, = 0.058). The transillumination method can allow plastic surgeons to easily identify the perforator vascular plexus of the ALT flap, which facilitates intraoperative flap design in head and neck reconstruction.

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Section: Discussionmentioning

confidence: 99%

Intraoperative Mapping of the Subfascial Plexus Using the Transillumination Method for Head and Neck Reconstruction with Free Style Anterolateral Thigh Flaps

Huang¹,

Huang²,

et al. 2018

Facial plast Surg

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show abstract

“…The concept, evolution, anatomy and design of propeller perforator flaps has been well studied. [8][9][10][11] With the revolutionary changes in microsurgery, the spectrum of free flap extended into the new territory of perforator-based flaps. [12][13][14][15][16] Cavadas et al in 2001 1 in their landmark study found out multiple perforating vessels coming out from gastrocnemius muscle supplying the skin in a fixed pattern.…”

Section: Discussionmentioning

confidence: 99%

Medial sural artery perforator free flap for the reconstruction of leg, foot and ankle defect: an excellent option

Balan¹

2017

ANZ Journal of Surgery

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“…Because of lack of availability in our inner city hospital, we have been limited to the audible Doppler to localize perforators and even that function is notoriously inadequate . Su et al have suggested that contrast‐enhanced ultrasound can safely allow, both inexpensively and without radiation, a preoperative perforator 3 dimensional imaging of the best perforator and its blood flow in a given region to allow the accurate design and orientation of a perforator flap that would minimize the risk of perfusion deficiencies. Others have shown that real‐time intraoperative laser assisted indo‐cyanine green imaging similarly permits perforator identification and flap design based on visualized perfusion coordinates, although in one report when used for optimizing the design of anterolateral thigh flaps, one partial flap loss still ensued .…”

Section: Discussionmentioning

confidence: 99%

Partial failure of a perforator free flap can be salvaged by a second perforator free flap

Hallock

2013

Microsurgery

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The root cause of partial failure of a perforator free flap was found to be either iatrogenic or de novo in origin. The proper design requires an awareness of the correct topographic axis and an understanding of the perforasome concept to better insure adequate flap perfusion. If a free flap is still considered the best solution after a partial failure, the advantages and benefit of a second perforator free flap should not be overlooked.

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Contrast-Enhanced Ultrasound Combined with Three-Dimensional Reconstruction in Preoperative Perforator Flap Planning

Abstract: Diagnostic, IV.

Cited by 44 publications

References 32 publications

Intraoperative Mapping of the Subfascial Plexus Using the Transillumination Method for Head and Neck Reconstruction with Free Style Anterolateral Thigh Flaps

Intraoperative Mapping of the Subfascial Plexus Using the Transillumination Method for Head and Neck Reconstruction with Free Style Anterolateral Thigh Flaps

Medial sural artery perforator free flap for the reconstruction of leg, foot and ankle defect: an excellent option

Partial failure of a perforator free flap can be salvaged by a second perforator free flap

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