Journal of reconstructive microsurgery最新文献

{"title":"Intraoperative Vasopressor Use Does Not Adversely Impact Free Flap Outcomes in Lower Extremity Limb Salvage Procedures in a Highly Comorbid Atraumatic Wound Population.","authors":"Rachel N Rohrich, Nicole C Episalla, Ryan P Lin, Sami Ferdousian, Julie Suh, Maeesha Noshin, Luke J Llaurado, Richard C Youn, Christopher E Attinger, Cameron M Akbari, Russell T Wall, Karen K Evans","doi":"10.1055/a-2687-0254","DOIUrl":"10.1055/a-2687-0254","url":null,"abstract":"<p><strong>Background: </strong>The use of vasopressors during microsurgical reconstruction is debated. Their effect on the comorbid lower extremity (LE) wound population is unstudied. This study characterizes the impact of intraoperative vasopressor use in LE free tissue transfer (FTT) for limb salvage.</p><p><strong>Methods: </strong>A review of LE FTT from February 2017 to June 2024 was conducted. Flap outcomes within 7 and 42 days were evaluated, as well as long-term limb salvage.</p><p><strong>Results: </strong>Of 258 LE FTT performed, vasopressors were used in 177 cases (68.6%). Most vasopressors were administered via intermittent bolus only (75.7%) or combined with continuous infusion (23.7%). American Society of Anesthesiologists Class was significantly higher in the vasopressor group compared with controls (<i>p</i> = 0.001). The vasopressor group trended to have higher median Charlson Comorbidity Indices (4, interquartile range [IQR]: 3 vs. 3, IQR: 3; <i>p</i> = 0.055), and rates of diabetes (65.0% vs. 54.3%, <i>p</i> = 0.103), peripheral vascular disease (63.8% vs. 51.9%, <i>p</i> = 0.068), and chronic kidney disease (14.7% vs. 6.2%, <i>p</i> = 0.063). The rate of reoperation, microvascular thrombosis, or flap success at 7 and 42 days did not differ between groups. By a median long-term follow-up of 24.5 (IQR: 39.2) months, rates of major limb amputation (vasopressor: 10.7% vs. control: 7.4%, <i>p</i> = 0.402) and mortality (6.8% vs. 2.5%, <i>p</i> = 0.237) were similar between groups.</p><p><strong>Conclusion: </strong>In this complex population, intraoperative use of vasopressors does not appear to negatively impact flap viability or limb salvage.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"449-460"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TMR/RPNI Awareness and Pain Outcomes: A Nationwide Survey of Amputees.","authors":"Aidan S Weitzner, Zachary H Zamore, Arushi Biswas, Jeffrey Khong, Keith T Kuo, Erica B Lee, William Padovano, Sami H Tuffaha","doi":"10.1055/a-2702-4167","DOIUrl":"10.1055/a-2702-4167","url":null,"abstract":"<p><strong>Background: </strong>Amputation leads to a symptomatic neuroma in 5 to 25% of amputees, causing debilitating pain. Targeted muscle reinnervation (TMR) and regenerative peripheral nerve interface (RPNI) are novel peripheral nerve interventions used to prevent/treat neuromas. Our objective was to assess whether amputees who underwent TMR or RPNI at primary amputation reported less pain and greater ability to use prosthetics than those receiving a delayed (secondary) TMR/RPNI or no TMR/RPNI.</p><p><strong>Methods: </strong>A REDCap survey was administered to 1,377 amputees and 294 responded. Participants were recruited via social media and the Amputee Coalition Web site. Amputees were queried on demographics, amputation, and quality-of-life characteristics. Knowledge of TMR/RPNI procedures was also assessed.</p><p><strong>Results: </strong>About 13 and 7% of patients had a primary and secondary TMR/RPNI, respectively. Outcomes were adjusted for amputation physician and clinical setting. Patients receiving primary TMR/RPNI had significantly lower pain severity score (<i>p</i> = 0.019) and pain interference score (<i>p</i> = 0.046) compared with no intervention. Pain with prosthetic use and proportion experiencing severe pain were not significantly lower among those receiving prophylactic TMR or RPNI.</p><p><strong>Conclusion: </strong>Compared with no or secondary peripheral nerve intervention, primary TMR/RPNI led to a significant reduction in pain interference and pain severity. Although not significant, preliminary trends also show reduction in pain with prosthetic use, proportion experiencing severe pain, and sustained opioid use with primary TMR/RPNI. As utilization of TMR/RPNI as a primary procedure yields better pain outcomes in a nationwide cohort, we must identify and address barriers to performance.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"491-498"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeon Experience and Outcomes in Microsurgical Breast Reconstruction: A 10-Year Single Surgeon Analysis.","authors":"Evan Rothchild, Isabelle T Smith, Stephen O Popoola, Joseph A Ricci, Neil Tanna","doi":"10.1055/a-2687-0207","DOIUrl":"10.1055/a-2687-0207","url":null,"abstract":"<p><strong>Background: </strong>Microsurgical breast reconstruction with deep inferior epigastric perforator (DIEP) flaps has become increasingly popular. While surgeons undergo rigorous training, it is believed that plastic surgeons continue to refine and enhance their performance through independent practice. This study evaluates the effect of surgeon experience on clinical outcomes in DIEP flap breast reconstruction.</p><p><strong>Methods: </strong>A retrospective review was conducted on consecutive DIEP flap procedures performed by a single surgeon from fellowship completion in 2013 to 10 years of independent professional practice in 2023. Patients were categorized into \"early\" and \"late\" groups, separated by a midpoint surgery date (July 30, 2018). Statistical analyses included student's <i>t</i>-tests, chi-squared analysis with Fisher's exact test, and multivariable regressions controlling for comorbidities.</p><p><strong>Results: </strong>The study included a total of 1,182 DIEP flaps in 632 patients, with 238 in the early group and 394 in the late group. The late group had a lower mean body mass index (28.83 vs. 29.98, <i>p</i> = 0.004), prevalence of hypertension (26.6% vs. 35.3%, <i>p</i> = 0.021), and prevalence of diabetes (7.9% vs. 14.3%, <i>p</i> = 0.010) than the early group. After controlling for potential confounders, the late group was independently associated with decreased length of stay (incidence rate ratio [IRR] = 0.611, <i>p</i> < 0.001) and fewer revision surgeries (IRR = 0.689, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>This large, single-surgeon series demonstrates that even with extensive initial training, plastic surgeons continue to evolve their surgical outcomes through accumulated experience. These findings emphasize the importance of consistent volume over time in achieving optimal results in microsurgical breast reconstruction.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"461-465"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Versatility of the Latissimus Dorsi Flap in Head and Neck Surgery: Supporting Evidence from a Tertiary Oncology Center.","authors":"Subhendu Khan, Varun Saini, Sanujit Apurv Pawde","doi":"10.1055/a-2632-2767","DOIUrl":"10.1055/a-2632-2767","url":null,"abstract":"","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"e1-e2"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Surgical Techniques for End-to-Side Neurorrhaphy in a Rat Model: A Quantitative and Qualitative Analysis of Postoperative Neural Repair and Recovered Nerve Function.","authors":"Daniel Staribacher, Dzmitry Kuzmin, Tomaz Velnar, Gavin Britz, Guenther C Feigl","doi":"10.1055/a-2702-4380","DOIUrl":"10.1055/a-2702-4380","url":null,"abstract":"<p><strong>Background: </strong>There are two basic techniques to surgically reconstruct peripheral nerves for the recovery of function after traumatic nerve injuries. The end-to-end (EtE) neurorrhaphy, and in case of loss of the proximal stump, the end-to-side (EtS) neurorrhaphy, where the distal end of the acceptor nerve is connected to the side of a donor nerve. The current study was designed to further contribute to finding the best surgical technique for an EtS neurorrhaphy, comparing the functional outcome in a rat model.</p><p><strong>Methods: </strong>Using a rat sciatic nerve model, qualitative and quantitative analyses were performed to evaluate peripheral nerve regeneration after EtS. A total of 22 female Lewis rats (Charles River Wiga, 190 g, 8 weeks old) were used for this study. In one test group (E1/<i>n</i> = 6), an EtS was conducted without, and in the other (E2/<i>n</i> = 8) with performing a partial neurotomy (PN) through the epineurial partial flap (EPF).</p><p><strong>Results: </strong>In the test groups (E1/E2), animals with EtS neurorrhaphy without PN reached the best mean functional score of 1.8 points according to our grading scale. Animals with EtS and PN scored with a mean of 2.2 points. These rats with EtS neurorrhaphy and PN had the poorest outcome. The control group C1 with EtE neurorraphies showed the best functional outcome with an average score of 1.</p><p><strong>Conclusion: </strong>The EtE represents the best surgical option for reconstruction of a nerve's anatomical continuity after transection if both ends are preserved. The EtS, on the other hand, represents a good alternative with almost equally good functional outcome in cases where the proximal nerve stump was lost. Results also indicate that an EPF should be created for optimal collateral axonal sprouting and the best possible results when performing an EtS. However, all other additional injuries of the donor nerve, such as a PN, should be avoided.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":"506-513"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infrared Temperature Monitoring in Vascularized Flaps with Simulated Arterial and Venous Thrombosis: An Animal Study.","authors":"Michela Schettino, Giorgia Fara, Gianluca Tognon, Francesco Mori, Luca Salmaso, Peter Axelsson, Paolo Sassu","doi":"10.1055/a-2886-9628","DOIUrl":"10.1055/a-2886-9628","url":null,"abstract":"<p><strong>Background: </strong>Early recognition of postoperative vascular compromise is critical for the success of vascularized free tissue transfer, with vascular thrombosis occurring in approximately 10% of cases. This study aimed to evaluate whether a portable infrared camera (FlirOne; FO) can detect skin surface temperature changes following simulated vascular occlusion in an animal model. Secondary objectives were to assess agreement between FO and an intracutaneous thermistor and to compare temperature patterns following arterial versus venous occlusion.</p><p><strong>Methods: </strong>A pedicled groin flap was raised in 32 female Sprague-Dawley rats. Animals were divided into four groups with simulated arterial or venous occlusion. The right side served as the intervention side, while the left acted as either a positive or negative control. Skin surface temperature was recorded at predefined time points before and after vessel ligation using FO and an intracutaneous thermistor.</p><p><strong>Results: </strong>Venous thrombosis was associated with an increase in flap temperature, whereas a consistent temperature decrease following arterial occlusion was not observed. The agreement between FO and the intracutaneous thermistor was moderate.</p><p><strong>Conclusion: </strong>Infrared temperature monitoring demonstrated a tendency toward temperature elevation in venous congestion, while temperature changes associated with arterial ischemia appeared to develop more slowly. These findings suggest that infrared thermography may be more sensitive to venous than arterial vascular compromise in this experimental model.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148239523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sequential, Noninvasive, Neurosensory Monitoring During Chemotherapy: Clinical Consequences of Identifying Neuropathy.","authors":"Norah Oles, Annelise Iverson, Nathanial H Williams, Nina Wagner-Johnson, Stuart Grossman, A Lee Dellon","doi":"10.1055/a-2856-1305","DOIUrl":"10.1055/a-2856-1305","url":null,"abstract":"<p><strong>Background: </strong>A significant proportion of patients experience symptoms of sensory nerve damage from chemotherapy known as chemotherapy-induced peripheral neuropathy (CIPN). CIPN is a major dose-limiting toxicity of many chemotherapeutic regimens. Early detection and quantification of CIPN is a significant challenge. It is hypothesized that noninvasive, nonpainful, pressure-specified sensory device (PSSD) will be a sensitive and specific tool for measuring CIPN. If CIPN can be detected early, then oncology might alter the drug regimen. Additionally, it is known that more than 33% of diabetics with neuropathy have a chronic nerve entrapment, as determined by a positive Tinel sign. If CIPN persisted after chemotherapy stopped, then presence of a peripheral nerve entrapment could be evaluated.</p><p><strong>Methods: </strong>A prospective cohort of patients receiving chemotherapy were referred by their oncologist. During the administration of their intravenous (IV) chemotherapy, the patient had PSSD testing of the index, little finger, and finger and big toe pulp. Quality-of-life outcome instruments QLQ-CIPN20, and the Michigan Neuropathy Symptom Score Instrument were administered. Each patient was evaluated for the presence of a Tinel sign at known sites of nerve entrapment. Inclusion criteria were patients receiving neurotoxic chemotherapy (Vincristine, Taxol, or Cisplatin).</p><p><strong>Results: </strong>Thirteen patients were enrolled. There were no complications from neurosensory testing. The PSSD was 80% sensitive and 100% specific identifying symptomatic neuropathy, <i>p</i> < 0.014, chi square and <i>p</i> < 0.05 using the Fisher's exact test. PSSD testing became abnormal prior to the patient becoming symptomatic and prior to the presence of a positive Tinel sign.</p><p><strong>Conclusion: </strong>Noninvasive and nonpainful neurosensory testing is feasible to do during chemotherapy IV infusion. This can identify changes in peripheral nerve function that correlate with a patient's symptoms and therefore might be used by the oncologist to alter the patient's chemotherapy dosage and limiting chemotherapy toxicity.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148226131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Availability and Need for Microsurgery-Trained Reconstructive Surgeons in Sub-Saharan Africa.","authors":"Meewon O Park, Nitya Devisetti, Nikki Thrikutam, Owen Muzinda, Natalie Meyers, Godfrey Muguti, James Chang","doi":"10.1055/a-2886-9733","DOIUrl":"10.1055/a-2886-9733","url":null,"abstract":"<p><strong>Background: </strong>Microsurgery is an essential component of plastic and reconstructive surgery, yet access remains limited in low- and middle-income countries (LMICs). The College of Surgeons of East, Central, and Southern Africa (COSECSA) region has identified a shortage of microsurgeons due to limited formal training, infrastructure needs, and resource constraints. This study aimed to assess the current microsurgical landscape in the COSECSA region, identifying key barriers and opportunities for training and practice development.</p><p><strong>Methods: </strong>A cross-sectional, survey-based needs assessment was conducted among plastic surgery attending microsurgeons and trainees in the COSECSA region (<i>n</i> = 20). The survey collected quantitative and qualitative data on microsurgical exposure, training experiences, clinical and structural needs, and opportunities for international collaboration.</p><p><strong>Results: </strong>Limited access to reliable equipment and supplies, insufficient funding, and inadequate institutional support were identified as major barriers to the development of microsurgical practices in this region. Key clinical needs included lower extremity and head and neck reconstruction, followed by reconstruction of craniofacial and burn conditions. Respondents emphasized the need for structured hands-on training, improved access to equipment, and international exchange programs to enhance microsurgical capacity in the COSECSA region.</p><p><strong>Conclusion: </strong>Addressing workforce shortages, improving microsurgery-specific training, and strengthening infrastructure are critical for expanding reconstructive microsurgical care in the COSECSA region. Given the current dearth of local training programs, international collaborations continue to play a vital role in bridging the gap in microsurgical training. However, to be effective, these partnerships should prioritize longitudinal, local engagement and capacity-building efforts to support the development of sustainable microsurgical practices in LMICs.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Preoperative Lower Extremity CT Angiography in Mandible Reconstruction: A Retrospective Cohort Analysis.","authors":"Jonathan Mohr, Jannik Ketschau, Yannik Leonhardt, Alex Grabenhorst, Hannes Singer, Helena Kram, Nils Krautkremer, Katharina Pippich, Klaus-Dietrich Wolff, Lucas M Ritschl","doi":"10.1055/a-2886-9931","DOIUrl":"10.1055/a-2886-9931","url":null,"abstract":"<p><strong>Background: </strong>Preoperative computed tomography angiography (CTA) of the lower extremities is commonly performed before fibula free flap (FFF) harvest for mandibular reconstruction. While CTA is intended to improve harvest side safety, its actual impact on reconstructive decision-making and postoperative outcomes remains insufficiently characterized.</p><p><strong>Methods: </strong>In this retrospective, single-center cohort study, patients undergoing mandibular continuity resection between July 2012 and June 2023 who received preoperative lower extremity CTA were analyzed. CTA-derived vascular parameters, including plaque presence, three-vessel run-off, and a bilateral vascular anomaly score, were systematically assessed. Associations with fibula flap selection (yes/no) and postoperative outcomes were analyzed using logistic regression and non-parametric statistical methods. Discriminatory performance was evaluated by receiver operating characteristic (ROC) analysis, including a combined CTA-based multivariable model.</p><p><strong>Results: </strong>A total of 247 patients were included. CTA-derived parameters were strongly associated with the decision to perform a reconstruction with FFF, but showed no consistent association with postoperative outcomes such as revision surgery, flap loss, or length of hospitalization. After directional alignment of predictors, ROC analysis demonstrated moderate to good discrimination for individual parameters, including absence of plaque on any side (area under the ROC curve [AUC] 0.745) and the inverted bilateral vascular anomaly score (AUC 0.686). A combined multivariable CTA-based model integrating all vascular parameters achieved excellent discrimination for FFF selection (AUC 0.826). None of the CTA-derived variables independently predicted postoperative complications. Notably, FFF reconstruction was also performed in a small subset of patients despite the absence of three-vessel run-off, without an apparent increase in postoperative complications.</p><p><strong>Conclusion: </strong>Lower extremity CTA primarily serves as a preoperative decision-support tool guiding FFF selection rather than as a predictor of postoperative outcomes. CTA-based vascular assessment enables effective upstream risk stratification and supports individualized reconstructive planning in mandibular reconstruction.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Hemodynamics of SCIA-SIEA System: A Foundation for Groin Flap Planning.","authors":"Zoe Cholbi Navarro, Marc Blasi, Daniel Aranda Domenech, Cristian Carrasco Lopez, Carmen Higueras Suñe","doi":"10.1055/a-2886-9874","DOIUrl":"10.1055/a-2886-9874","url":null,"abstract":"<p><strong>Background: </strong>The superficial circumflex iliac artery perforator (SCIP) flap has become an essential option in reconstructive microsurgery. However, the arterial anatomy of the groin region demonstrates substantial variation, with reports of superficial circumflex iliac artery (SCIA) hypoplasia necessitating reliance on the superficial inferior epigastric artery (SIEA) as an alternative vascular source. This study aimed to characterize and compare hemodynamic differences among these arteries to determine whether physiological, in addition to morphological, variability exists.</p><p><strong>Methods: </strong>Ultrasound was used to assess morphological and physiological parameters of the SCIA superficial and deep branches, as well as the SIEA, in 54 inguinal regions from 27 healthy volunteers. Measurements were obtained at defined anatomical landmarks, recording peak systolic velocity (PSV) and resistance index (RI). Cases were categorized based on PSV distribution patterns to describe relative flow predominance and potential variations in vascular contribution between arteries.</p><p><strong>Results: </strong>Significant differences were noted in PSV among the three arteries (<i>p</i> < 0.00001), primarily between the SCIA branches and the SIEA (superficial SCIA vs. SIEA, <i>p</i> < 0.00001; deep SCIA vs. SIEA, <i>p</i> < 0.00001). Three main flow distribution patterns were described: Dominance of a single artery (18.5%), a single underdeveloped artery with reduced PSV (64.8%), and balanced flow among all three arteries (16.7%). No significant side-to-side differences were observed (all <i>p</i> > 0.75).</p><p><strong>Conclusion: </strong>Distinct interindividual hemodynamic patterns of arterial perfusion in the groin region can be identified using ultrasound, and baseline reference values are established to support further validation of preoperative mapping for SCIP and SIEA flaps.</p>","PeriodicalId":16949,"journal":{"name":"Journal of reconstructive microsurgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}