The comparison of color Doppler ultrasound and computed tomography angiography in the preoperative planning of lower extremity perforators / 中华显微外科杂志

ABSTRACT

Objective To compare the application of CDU and CTA in preoperative planning of lower extremity perforator flaps.Methods From February, 2013 to December, 2014, 40 patients who underwent reconstruction with perforator flaps harvested from lower extremities were treated.The position, caliber and route of the perforator vessels were detected by CDU and CTA pre-operatively.The results of the pre-operative navigation with both imaging techniques assisted the selection of the perforators and the flap design and were verified during the operation.Results CDU had a higher accuracy in terms of identification (95.0％ vs.90.0％) and location (95.0％ vs.82.5％) of the perforators in the lower extremity.There was no significant difference between the two methods in examination and image analysis time.All the flaps survived, besides 1 flap presented with a 2.0 cm × 2.0 cm distal necrosis which healed after regular dressing change.For 35 cases, the donor sites were closed directly while partial skin grafting were performed in 5 case.Conclusion Pre-operative imaging techniques are capable of offering valuable anatomical information of perforator vessels, which can make flap design more convenient, reduce donor site morbidity and improve the surgical results.The authors recommend CDU for pre-operative planning when harvesting perforator flaps from the lower extremity.