Does Preoperative Vascular Mapping Using Color-Doppler Ultrasound have a Role in the Success of Axial Nasolabial Flap?

Abstract

Aim: The study was performed to compare the effects of preoperative vascular mapping on the clinical outcome of axial nasolabial flap.

Materials and methods: A total of 26 patients (29 flaps) were alternately divided into two groups using simple block randomization method. In Group I patients, the conventional axial flap was marked. In Group II, USG-guided flap was designed with the help of Color-Doppler ultrasound. Patients were assessed for a minimum of 6 months and the postoperative flap outcome was quantified using a self-validated composite scoring system. Other parameters of patient morbidity including length of hospital stay, resurgery for reconstruction of secondary defects, postoperative complications were also measured and compared.

Results: The mean postoperative flap outcome score was significantly superior in Group II patients than Group I, at the beginning and at the conclusion of the study (intergroup p-value at postoperative-1-week = .001; at postoperative-1-month = .044; at postoperative-3-month = .139; at postoperative-6-month = .007). Additionally, reconstruction defects with the conventional nasolabial flap were associated with greater morbidity as compared to Group II (intergroup comparison-hospital stay and duration p = .001; complications p = .115; Redo Surgery p = .096).

Conclusion: Therefore, it can be concluded that flap selection based on known dominant perforators could be helpful in achieving favorable outcomes resulting in minimal postoperative morbidity while allowing complex surgical reconstructions.