Heneweer, Carola, Zirk, Matthias, Safi, Ali, Smeets, Ralf, Malter, Wolfram, Kroeger, Nadja, Zoeller, Joachim E., Maintz, David and Zinser, Max (2021). An Innovative Approach for Preoperative Perforator Flap Planning Using Contrast-enhanced B-flow Imaging. PRS-GLOB. OPEN, 9 (5). PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 2169-7574

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Abstract

Precise perforator mapping of the epifascial and subcutaneous course of the perforator flaps, including the precise detection of the skin point, is mandatory for successful preoperative flap design and planning of supramicrosurgery. We investigated the effectiveness of contrast-enhanced B-flow (BCEUS) imaging for perforator mapping and preoperative perforator flap planning and compared it with B-flow ultrasound, contrast-enhanced ultrasound, and color Doppler ultrasound. Sixteen patients who received an individualized perforator flap reconstruction were included in the study. Preoperative perforator mapping includes the following structures: subfascial course of the pedicle, fascial penetration point, subcutaneous course (epifascial and subcutaneous), and perforator skin point. The precision of the preoperative perforator mapping was analyzed for color Doppler ultrasound, contrast-enhanced ultrasound, B-flow ultrasound, and BCEUS. Each technique was able to precisely display the subfascial course of the vascular pedicle, including the fascial penetration point. However, only BCEUS enabled precise mapping of the epifascial and subcutaneous (suprafascial) course, including the skin point of the perforators with a clear delineation. Precise knowledge of the suprafascial course of the perforators is mandatory for successful supermicrosurgery and perforator flap planning. BCEUS imaging facilitates full perforator mapping, which improves the safety of flap harvesting. However, BCEUS is technically demanding and requires an experienced sonographer.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Heneweer, CarolaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zirk, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Safi, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smeets, RalfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Malter, WolframUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kroeger, NadjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zoeller, Joachim E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maintz, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zinser, MaxUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-593027
DOI: 10.1097/GOX.0000000000003547
Journal or Publication Title: PRS-GLOB. OPEN
Volume: 9
Number: 5
Date: 2021
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 2169-7574
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
COLOR DOPPLER ULTRASOUND; RECONSTRUCTIONMultiple languages
SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/59302

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