With the development of microvascular technology, perforator flaps have gradually become a good alternative for reconstruction of tissue defects. However, the major limitations of perforator flaps include uncertainty in predicting anatomical location of perforators and high variability in perforator size and course, which require preoperative localization techniques. Recently, as one of the preoperative localization techniques, computed tomography angiography was used to determine the number, size, course, and exact emerging point of perforator flaps. Clinicians can reduce surgical complications and shorten operative time by using computed tomography angiography. However, only several studies reported clinical applications of computed tomography angiography. This article reviews characteristics, classification, and preoperative location techniques for perforator flaps and its problems.
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http://dx.doi.org/10.7518/hxkq.2017.06.018 | DOI Listing |
Ann Plast Surg
February 2025
From the Department of Plastic and Reconstructive Surgery, Ewha Womans University College of Medicine, Mokdong Hospital, Seoul, Republic of Korea.
Indocyanine green (ICG) is a water-soluble green substance that is detectable through infrared cameras and emits greenish light. Approved for medical use in the 1950s, ICG has gained prominence as a real-time visualization tool. Widely recognized as a generally safe substance, ICG is applied in diverse fields.
View Article and Find Full Text PDFLaryngoscope Investig Otolaryngol
February 2025
Background: The main technique for identification of free flap perforator vessels is Doppler sonography, which is not always accurate, user dependent and affected by the patient's body habitus.
Methods: Adult patients undergoing head and neck resection and free flap reconstruction at two academic institutions were enrolled. Doppler sonography was used to identify perforators, and were marked using a skin marker.
Plast Reconstr Surg Glob Open
January 2025
Division of Plastic, Reconstructive and Aesthetic Surgery, University of Toronto, Toronto, ON, Canada.
Background: Breast reconstruction with the deep inferior epigastric perforator (DIEP) free flap has become the gold standard for autologous breast reconstruction. Flap take-back to the operating room (OR) is an uncommon but difficult situation, requiring prompt and accessible resources. We conducted a literature review and independent expert review to inform evidence-based perioperative algorithms in the event of DIEP flap compromise.
View Article and Find Full Text PDFMicrosurgery
January 2025
Department of Plastic and Reconstructive Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
Background: Pressure ulcers are a prevalent and debilitating condition, often necessitating surgical reconstruction. Various flap techniques, such as Advancement Flaps (AF) and Perforator-based Propeller Flaps (PBPF), are commonly used for pressure sore reconstruction. While both techniques have proven effective, there is limited research comparing their outcomes in different clinical scenarios.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
Introduction: Despite its therapeutic advantages, postmastectomy radiotherapy (PMRT) increases the risk of complications and often leads to poor cosmesis in women undergoing breast reconstruction. Preoperative radiotherapy followed by skin-sparing mastectomy and deep inferior epigastric perforator (DIEP) flap reconstruction is technically feasible, with low rates of surgical complications and good short-term oncological outcomes. Further evaluation in a randomised trial comparing preoperative radiotherapy versus conventional PMRT in breast reconstruction is required to assess both oncological and patient-reported outcomes (PROs).
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