Identifying Perforators in Reconstructive Surgery

Pedicled perforator flaps allow the surgeon to relocate local tissue and facilitate a simple reorganization, which enables an optimal cosmetic and functional reconstructive outcome. They provide a fast and simple, single-stage solution and offer an alternative to microsurgery or skin graft.

Color Doppler ultrasonography is useful to identify perforators and aid in the planning of flap reconstructions. It provides additional visual information about available soft tissue, vessel flow patterns, vessel course through the soft tissue as well as perforator size and location. 

Which Ultrasound Scanner is suitable for Identifying Perforators in Reconstructive Surgery?

Plastic and reconstructive surgeons use the Wireless Color Doppler Linear Ultrasound Scanner L2CD while performing the procedure. In which it is useful for locating the position of individual perforating vessels, making it much easier to find them during the operation.

Linear Ultrasound Scanner L2CD, is a special ultrasound technique that allows the physician to see and evaluate blood flow through arteries and veins in the abdomen, arms, legs, neck, and/or brain (in infants and children) or within various body organs.

The individual perforating vessels have a high degree of anatomical variation, therefore it is desirable to conduct a careful examination of them before undertaking a perforator flap operation.

Some studies have shown that Color Doppler Ultrasound is more precise in the detection of perforating arteries of the anterolateral thigh. The CDU can visualize the perforator passage through the fascia.

The Color Doppler Ultrasound examination could easily identify the locations, numbers, and the courses of the cutaneous perforators and help in the useful assessment of vascularity to confirm the existence and location of appropriate perforators for the design of the SDMC flap.

To sum up, using this CDU examination, difficulties owing to the anatomical variation of perforators are easily overcome, simplifying the flap harvest.

References: Color Doppler Ultrasonography, Color Doppler ultrasonography targeted reconstruction using pedicled perforator flaps