High-frequency ultrasound-assisted perforator mapping enhances efficiency in microsurgical reconstruction using thin ALT and SCIP flaps

IF 1.5 3区医学 Q3 SURGERY

Microsurgery Pub Date : 2024-03-28 DOI:10.1002/micr.31171

Sang-Hun Lee MD, Kyeong-Tae Lee MD, PhD

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引用次数: 0

Abstract

Background

With the growing demand for the use of thin perforator flaps, obtaining knowledge on the superficial anatomy of perforators is imperative for stable flap elevation. Conventional modalities for perforator mapping fall short in providing such information. High-frequency ultrasound (HFUS), known for visualizing the superficially located anatomic structures, may potentially fill this void. This study aimed to evaluate the effectiveness of HFUS in the outcome of anterolateral thigh (ALT) and superficial circumflex iliac artery perforator (SCIP) flap-based reconstructions.

Methods

Consecutive patients who underwent free ALT or SCIP flap-based reconstruction from January 2021 to November 2022 were retrospectively reviewed. Perforator mapping was conducted using a handheld Doppler during the first year, while HFUS was used in the latter part. The two techniques were compared in terms of flap harvesting time and perfusion-related complication rates while considering the flap elevation plane.

Results

In total, 123 cases were analyzed, including 82 ALT flaps (41 in each group) and 41 SCIP flaps (16 in the Doppler and 25 in the HFUS group). The time required for flap elevation exhibited a tendency to decrease in the HFUS group, with a significant difference observed in cases involving thin flap elevation (super-thin ALT flaps and pure-skin-perforator SCIP flaps). Compared with the Doppler group, the HFUS group demonstrated significantly lower rates of PRCs, particularly partial flap necrosis. This difference remained significant in multivariable analyses.

Conclusion

Our results suggest that HFUS might be an appealing modality for perforator mapping in cases requiring thin ALT and SCIP flap.

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高频超声辅助穿孔器绘图提高了使用薄型 ALT 和 SCIP 皮瓣进行显微外科重建的效率。

背景：随着使用薄穿孔器皮瓣的需求日益增长，获得穿孔器表层解剖知识对于稳定皮瓣隆起至关重要。传统的穿孔器绘图方法无法提供此类信息。高频超声（HFUS）以可视化浅表解剖结构而著称，有可能填补这一空白。本研究旨在评估高频超声在基于大腿前外侧（ALT）和髂浅环动脉穿孔器（SCIP）皮瓣重建中的效果：回顾性分析2021年1月至2022年11月期间接受游离ALT或SCIP皮瓣重建术的连续患者。第一年使用手持多普勒进行穿孔器测绘，后一年使用高频超声。比较了两种技术的皮瓣采集时间和灌注相关并发症发生率，同时考虑了皮瓣隆起平面：共分析了123个病例，包括82个ALT皮瓣（两组各41个）和41个SCIP皮瓣（多普勒组16个，HFUS组25个）。在 HFUS 组中，皮瓣提升所需的时间呈减少趋势，在涉及薄皮瓣提升的病例（超薄 ALT 皮瓣和纯皮肤穿孔器 SCIP 皮瓣）中观察到显著差异。与多普勒组相比，HFUS 组的 PRC 发生率明显较低，尤其是部分皮瓣坏死。这一差异在多变量分析中仍有意义：我们的研究结果表明，在需要薄型 ALT 和 SCIP 皮瓣的病例中，HFUS 可能是一种有吸引力的穿孔器测绘方式。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microsurgery 医学-外科

CiteScore

3.80

自引率

19.00%

发文量

128

审稿时长

4-8 weeks

期刊介绍： Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.