Reconstructive microsurgery using free and pedicled flaps has become a reliable method with a high success rate. Preoperative perforator mapping and intraoperative assessment of perfusion might further reduce flap-associated morbidity.There are various techniques for perforator mapping and perfusion measurement, but no guidelines regarding their use. Therefore, an expert panel at the 40th Annual Meeting of the German-Speaking Working Group for Microsurgery of the Peripheral Nerves and Vessels (DAM) discussed and critically reviewed the current literature. The consensus statement represents the expert opinion based on the available literature and provides recommendations regarding the use of preoperative perforator mapping and intraoperative perfusion measurement.
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http://dx.doi.org/10.1055/a-0987-0118 | DOI Listing |
Microsurgery
January 2025
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Thinning of anterolateral thigh flap is challenging. Anatomical studies have shown variations in arterial branching patterns in the subcutaneous layer, which were suspected to be the reason for the high frequency of thinning failures. We attempted to visualize subcutaneous arterial courses preoperatively and perform thinning of perforator flaps using this information appropriately.
View Article and Find Full Text PDFIndian J Plast Surg
December 2024
Department of Plastic Reconstructive Surgery, ASST Valle Camonica, Esine, Brescia, Italy.
The keystone design perforator island flap (KDPIF) was first described by Behan in 2003 as a pliable flap, suitable for all body areas thanks to its curvilinear shape, which made it apt to fit mostly all cutaneous defects. In this article, we aim to share our experience using KDPIF for the reconstruction of different defects. A retrospective analysis of patients who underwent cutaneous excision after trauma or tumor resection and reconstruction with a KDPIF at our department from 2020 to 2023 was performed.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
December 2024
From the Division of Surgery and Interventional Science, University College London, London, United Kingdom.
Background: The deep inferior epigastric perforator (DIEP) flap provides an effective and popular means for autologous breast reconstruction. However, with the complexity of the pathway, the environmental impact of the pathway has yet to be evaluated.
Methods: A retrospective analysis of 42 unilateral DIEPs at a single reconstructive center was performed.
J Vasc Bras
November 2024
Pontifícia Universidade Católica do Paraná - PUCPR, Curitiba, PR, Brasil.
Background: The Giacomini vein (GV) can transfer reflux from perineal veins, tributary veins, and perforators of the thigh to the small saphenous vein (SSV). Vascular ultrasound with Doppler (VUD) is the preferred method for detecting reflux in specific veins such as the GV.
Objective: To identify GV depth and diameter, reflux in the GV, and presence of reflux in the SSV caused by the GV.
J Plast Reconstr Aesthet Surg
January 2025
Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address:
Background: The anterolateral thigh (ALT) flap is a reliable and versatile flap with the ideal characteristics for soft-tissue reconstruction. However, as it is known for its highly variable anatomy, it requires preoperative perforator localization to optimize flap design and dissection of the flap. Dynamic Infrared Thermography (DIRT) is a non-invasive and quick imaging method that provides real-time information.
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