Portable Color-Flow Ultrasound Facilitates Precision Flap Planning and Perforator Selection in Reconstructive Plastic Surgery.

Abstract:

BACKGROUND:Precise flap planning and perforator selection are paramount for successful perforator flap surgery. Portable color-flow ultrasound (PCFU) is a convenient, low-cost, easily accessible imaging modality that is pivotal in the planning of perforator flaps where anatomic variability is the rule. METHODS:Perforator mapping was performed using an L12-4 linear-array ultrasound probe connected to an Android tablet. Images were obtained with the Lumify app (Philips Lumify, usa.philips.com). Perforator characteristics were recorded (arterial diameter, emergence points from fascia, subcutaneous course, and projection onto the skin surface) using still images and real-time videos. RESULTS:Thirty consecutive patients had 40 perforator or musculocutaneous flap reconstructions over a 2-year period. For the 15 flaps that had preoperative computed tomographic angiography (CTA) imaging, the preoperative sonographic measurements correlated with CTA and intraoperative findings. Portable color-flow ultrasound allowed perforator flap design and selection based on the largest available perforator, the most appropriate flap thickness, and comparison of multiple donor sites including left versus right. Two deep inferior epigastric perforator patients required take-back to the operating room for debridement of devitalized nonflap tissue. The superior gluteal artery perforator flap was abandoned intraoperatively due to proximal vascular anomalies. Overall flap success rate was 98% (39/40 flaps). CONCLUSIONS:Our experience with PCFU has rapidly improved, allowing individualized perforator flap selection and design based on each patient's unique perforator anatomy, reconstructive requirements, and donor site characteristics. In our practice, PCFU has supplemented CTA and in many cases has supplanted CTA as the primary imaging modality of choice in the planning of perforator flap reconstruction.

journal_name

Ann Plast Surg

authors

Homsy C,McCarthy ME,Lim S,Lindsey JT Jr,Sands TT,Lindsey JT Sr

doi

10.1097/SAP.0000000000002203

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

S424-S430

issue

6S Suppl 5

eissn

0148-7043

issn

1536-3708

journal_volume

84

pub_type

杂志文章
  • The use of biomedical sensors to monitor capsule formation around soft tissue implants.

    abstract::Piezoelectric sensors have been shown to respond reproducibly to changes in tissue mechanical properties surrounding an implant over a 4-month period. The vibrational amplitude at a frequency corresponding to the radial resonance shows a statistically significant change over time. The initial period of inflammation is...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/01.sap.0000189620.45708.5f

    authors: Bender JW,Friedman HI,Giurgiutiu V,Watson C,Fitzmaurice M,Yost ML

    更新日期:2006-01-01 00:00:00

  • Surgical treatment of axillary hyperhidrosis: a study comparing liposuction cannulas with a suction-curettage cannula.

    abstract:BACKGROUND:Suction-curettage is a minimally invasive surgical approach for the treatment of focal axillary hyperhidrosis. Studies comparing the efficacy of different surgical cannulas are missing. Therefore, we gravimetrically compared a specially designed cannula versus 2 standard liposuction cannulas. METHODS:Axilla...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/01.sap.0000205771.40918.b3

    authors: Bechara FG,Sand M,Sand D,Altmeyer P,Hoffmann K

    更新日期:2006-06-01 00:00:00

  • The safety of and indications for immediate reconstruction of head and neck melanoma defects: our early experience.

    abstract::Melanoma excision requires wide margins, leaving large defects. Surgical dogma has taught that definitive reconstruction of melanoma defects be performed after permanent pathology results, with skin grafts favored. However, this results in an open wound and the need for a second operation. The advantages of immediate ...

    journal_title:Annals of plastic surgery

    pub_type: 临床试验,杂志文章

    doi:10.1097/SAP.0000000000000166

    authors: Parrett BM,Kashani-Sabet M,Leong SP,Buncke N,Singer MI

    更新日期:2014-05-01 00:00:00

  • Changes in blood flow and metabolism in a neurovascular island skin flap after a burn.

    abstract::In 8 male white Yorkshire pigs weighing approximately 42 kg each, 12 buttock neurovascular island skin flaps were dissected. Baseline recordings were made of blood flow and O2 consumption in the flap. Two series of experiments were carried out. In control animals (5), the flap was dissected and the "cold" aluminum pla...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-198607000-00014

    authors: Eriksson E,Miles RD,Le HQ

    更新日期:1986-07-01 00:00:00

  • Combined laser therapy for difficult dermal pigmentation: resurfacing and selective photothermolysis.

    abstract::Treating pigmented lesions of the skin, especially deep dermal pigmentations, are difficult to achieve satisfactory results without complications. To treat dermal pigmentations, such as nevus of Ota and congenital nevus, the combined therapy of a resurfacing laser (CO2) and a selective photothermolytic laser (the Q-Sw...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-200107000-00006

    authors: Park SH,Koo SH,Choi EO

    更新日期:2001-07-01 00:00:00

  • Three-Dimensional Analysis of Mandibular Angle Classification and Aesthetic Evaluation of the Lower Face in Chinese Female Adults.

    abstract:BACKGROUND:Reduction gonioplasty is very popular in East Asia. However, there has been little quantitative criteria for mandibular angle classification or aesthetics. The aim of this study was to investigate the quantitative differences of mandibular angle types and determine the morphologic features of mandibular angl...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/SAP.0000000000001463

    authors: Mao X,Fu X,Niu F,Chen Y,Jin Q,Qiao J,Gui L

    更新日期:2018-07-01 00:00:00

  • Comparing Muscle and Fasciocutaneous Free Flaps in Lower Extremity Reconstruction--Does It Matter?

    abstract:INTRODUCTION:Plastic surgeons are often asked to assist with the reconstruction of lower extremity wounds. These patients many times require free tissue transfer for coverage given paucity of soft tissue. Anecdotally, many orthopedic surgeons prefer muscle coverage--particularly in the setting of potentially infected b...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/SAP.0000000000000779

    authors: Paro J,Chiou G,Sen SK

    更新日期:2016-05-01 00:00:00

  • Prenatal pressure necrosis of the scalp.

    abstract::A case of full-thickness pressure necrosis of the scalp in a newborn is reported. This is a rare injury, with only four similar prior reports found in the literature. The presumed mechanism of injury is pressure of the infant's head against the mother's bony pelvis. A spectrum of injury can be seen, from temporary alo...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-199907000-00011

    authors: Matthews MS

    更新日期:1999-07-01 00:00:00

  • Gluteal infarction as a complication of aortofemoral bypass grafting.

    abstract::Early complications following aortofemoral bypass grafting include acute limb ischemia, renal failure, bowel and spinal cord ischemia, and myocardial infarction. Although the literature recognizes these more common complications, we have found very few reports that raised the possibility of an anatomically determined,...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-199612000-00014

    authors: Ho PR,Yim K,Hui K,Lineaweaver WC

    更新日期:1996-12-01 00:00:00

  • Managing Vascular Anomalies in the Era of Genetics and Precision Medicine: An Opportunity or a Challenge?

    abstract:ABSTRACT:The era of genetics and precision medicine has been reforming this world. How will plastic surgeons in the field of vascular anomalies conform to the trend? This article systematically reviews the identification of serum biomarkers, risk factors, specific mutations in the angiogenesis-related genes such as GNA...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/SAP.0000000000002723

    authors: Gu H,Liu H,Cai R,Chen H,Lin X

    更新日期:2021-01-19 00:00:00

  • An alternative frontalis suspension technique: triband suspension--a modified Garcia's procedure.

    abstract::Blepharoptosis surgery is one of the most common oculoplastic procedures, and the aim is to clear the visual axis. Many surgical techniques for the correction of ptosis have been described and performed, but the operative approach is based on the extent of eyelid excursion, the amount of levator function, and the degr...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/SAP.0b013e3181de838a

    authors: Benlier E,Bozkurt M,Kulahci Y,Kapi E,Sahin C

    更新日期:2011-03-01 00:00:00

  • A case study of a patient with closed avulsion rupture of a single slip of the flexor digitorum superficialis tendon.

    abstract::A case of a closed rupture of a single slip of flexor digitorum superficialis to the little finger is described. Closed rupture injuries of the flexor digitorum profundus tendon are quite common, but closed injuries to the superficialis tendon have been rarely reported. A single slip avulsion rupture of this tendon wo...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-200110000-00012

    authors: Netscher DT,Eladoumikdachi F,Schneider A

    更新日期:2001-10-01 00:00:00

  • Calvarial bone healing under spring distension at continuous forces.

    abstract::The aim of the present study was to evaluate in young animals the dynamics of calvarial bone healing when exposing a bone defect to continuous forces for up to 13 weeks. Six-week-old rabbits after a sagittal suture strip craniectomy were randomized for either of the following protocols: (1) no spring was applied (n = ...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/01.sap.0000229019.29857.14

    authors: Pignatti M,Hansson HA,Gewalli F

    更新日期:2006-11-01 00:00:00

  • Immediate reconstruction of simple lacerations.

    abstract::A subjective description of a technique of immediate reconstruction of cutaneous defects due to laceration is presented. Extension of the use and range of the Z-plasty is emphasized and its benefits and limitations are discussed. The reconstructive surgeon is challenged to consider wider and more frequent use of these...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-197809000-00003

    authors: Metzger JT

    更新日期:1978-09-01 00:00:00

  • Effects of vasoactive medications on the blood flow of island musculocutaneous flaps in swine.

    abstract::Pedicled flaps and microsurgical free tissue transfers are increasingly being used for reconstruction in the elderly and poorer risk patient. The use of systemically administered vasoactive agents to date has been avoided because of the fear that systemic levels of these agents perioperatively (particularly the vasopr...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-199711000-00013

    authors: Cordeiro PG,Santamaria E,Hu QY,Heerdt P

    更新日期:1997-11-01 00:00:00

  • Outcome of Pedicled Thoracodorsal Artery Perforator Flap in the Surgical Treatment of Stage II and III Hidradenitis Suppurativa of Axilla.

    abstract:BACKGROUND:Hidradenitis suppurativa (HS) is a chronic, inflammatory disease affecting the apocrine glands of the axillary, groin, and mammary regions with significant physical and psychosocial sequelae. Surgical excision of the affected tissue is the criterion standard treatment. Advanced cases of axillary HS are assoc...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/SAP.0000000000001658

    authors: Elgohary H,Nawar AM,Zidan A,Shoulah AA,Younes MT,Hamed AM

    更新日期:2018-12-01 00:00:00

  • Complications of laser therapy in the gynecological patient: a review of four patients.

    abstract::Complications of gynecological laser treatment for perineal disease have been seen with increasing frequency. This may be the result of more women undergoing therapy with this method. Four women presenting with unstable perineal scarring are discussed. ...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-199110000-00015

    authors: Lawson AE,Hawtof D,Gowda M,Jackson I,Osgood G

    更新日期:1991-10-01 00:00:00

  • Improvement of erythematous and hypertrophic scars by the 585-nm flashlamp-pumped pulsed dye laser.

    abstract::Fourteen patients with erythematous and/or hypertrophic scars resulting from remote surgical excision or trauma were evaluated and subsequently treated with one to two flashlamp-pumped pulsed dye (585 nm) laser treatments over a 2-month period. Clinical assessments were performed before commencement and at the end of ...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-199402000-00015

    authors: Alster TS

    更新日期:1994-02-01 00:00:00

  • Functional Outcomes of Surgical Management of Mandibular Condylar Head Fractures.

    abstract:BACKGROUND:Various procedures have been described for the management of mandibular condylar head fracture, but a standard treatment is not yet conclusive. This report describes our experience with osteosynthesis of condylar head fracture at Linkou Chang Gung Memorial Hospital. METHODS:Sixteen patients with unilateral ...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/SAP.0000000000002172

    authors: Lai BR,Liao HT

    更新日期:2020-01-01 00:00:00

  • Toward an understanding of nonsyndromic craniosynostosis: altered patterns of TGF-beta receptor and FGF receptor expression induced by intrauterine head constraint.

    abstract::Although the etiology of nonsyndromic forms of craniosynostosis remains uncertain, recent experiments from our laboratory have demonstrated that fetal head constraint induces cranial suture fusion in mice through a process associated with altered patterns of transforming growth factor beta (TGF-beta) isoform expressio...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-200105000-00015

    authors: Hunenko O,Karmacharya J,Ong G,Kirschner RE

    更新日期:2001-05-01 00:00:00

  • Microsurgical reconstruction of noma-related facial defects with folded free flaps: an overview of 31 cases.

    abstract::Noma is primarily affecting children in underprivileged countries and results in disfiguring facial defects, loss of mandibular movement, and subsequent social disintegration. Plastic surgery in West Africa traditionally uses pedicled flaps. In large, complex, or central facial defects, though, pedicled flaps are apt ...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/01.sap.0000165688.50780.e9

    authors: Giessler GA,Fieger A,Cornelius CP,Schmidt AB

    更新日期:2005-08-01 00:00:00

  • Divided latissimus dorsi musculocutaneous flap for chest wall radionecrosis.

    abstract::A 69-year-old woman with a history of mastectomy and radiotherapy for breast carcinoma demonstrated extensive anterior thoracic wall radionecrosis 22 years later. The latissimus dorsi musculocutaneous flap was chosen to repair two distant ulcerative defects. Chest wall coverage was performed by dividing the muscle int...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-199410000-00011

    authors: Rouanet P,Jozwik M,Pujol H

    更新日期:1994-10-01 00:00:00

  • Long-term follow-up of a modified Anton-Hartrampf nipple reconstruction.

    abstract::This study was performed to determine the degree of shrinkage over time in nipple projection after reconstruction. Nipple-areolar reconstruction was performed using the modified Anton-Hartrampf technique, and pigmentation was achieved with tattooing. This study looked at 28 consecutive patients with nipple reconstruct...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-199911000-00001

    authors: Banducci DR,Le TK,Hughes KC

    更新日期:1999-11-01 00:00:00

  • Neurofibromas of the breast and nipple-areolar area.

    abstract::Neurofibromas are common tumors that arise from elements in the peripheral nervous system. The vast majority occur in the trunk and are usually limited to the head and neck area. We present two cases involving the skin of the breast and nipple-areolar complex and the method of treatment. ...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-198110000-00010

    authors: Sherman JE,Smith JW

    更新日期:1981-10-01 00:00:00

  • Breastfeeding after augmentation mammaplasty with saline implants.

    abstract::It has been reported that breastfeeding problems occur in women who have breast implants. The breastfeeding success of women who had augmentation with saline implants and subsequently had a live birth (n = 107) was compared with that of women of similar age who had hypoplastic breasts and had children before their con...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/SAP.0b013e3181c925e4

    authors: Cruz NI,Korchin L

    更新日期:2010-05-01 00:00:00

  • Nonendoscopic harvest of the gastrocnemius muscle flap through a small incision.

    abstract::Traditional gastrocnemius flap harvest requires a long skin incision, starting from the popliteal fossa to the mid leg. The authors designed three instruments to facilitate harvest of this flap through a small incision without the help of an endoscope in 10 patients. All 10 gastrocnemius muscle flaps survived with a 1...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-200108000-00005

    authors: Tsai CC,Lin TM,Lai CS,Lin SD

    更新日期:2001-08-01 00:00:00

  • Node-positive transcranial recurrent melanoma: is an aggressive resection warranted?

    abstract::Locally advanced, node-positive recurrence of malignant melanoma is a harbinger of distant metastases and signifies poor prognosis. However, the clinical course may vary due to the unpredictable biology of malignant melanoma. The presented patient developed a recurrent melanoma of the scalp that eroded through the sku...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/01.sap.0000154033.03763.cd

    authors: Senchenkov A,Barone FE

    更新日期:2005-05-01 00:00:00

  • A late, fatal complication of a high energy thermal injury to the scalp.

    abstract::Marjolin's ulcer is an uncommon condition in which malignant transformation occurs in a chronic inflammatory focus. It was originally described in association with a thermal injury, however, its occurrence with protean chronic inflammatory foci has been described. We report the occurrence of and aggressive squamous ca...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-199512000-00016

    authors: Clements B,Lewis H,Lewis H,McKinstrey S,Gray J,Byrnes D

    更新日期:1995-12-01 00:00:00

  • Use of the balloon dissector in minimally invasive aesthetic and reconstructive surgery.

    abstract::The use of minimally invasive surgery continues to evolve in all fields of surgery with new developments in techniques and instrumentation. One instrument that has evolved and become useful in the field of plastic surgery is the balloon dissector. The purpose of this paper is to examine the role of the balloon dissect...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/00000637-199803000-00002

    authors: Ip TY,Aponte R,Koger KE,German G,Zobrist R,Levin LS

    更新日期:1998-03-01 00:00:00

  • Defining a New Variable That May Impact Long-term Postoperative Nasal Tip Support: The Biomechanical Properties of the Columellar Strut Graft.

    abstract:BACKGROUND:Although columellar strut grafts (CSGs) are considered among the fundamental steps for providing nasal tip support, a downward rotation of the nasal tip in patients with strut grafts can still be encountered. Patient-related factors such as nasal skin thickness can allow the plastic surgeon to anticipate cer...

    journal_title:Annals of plastic surgery

    pub_type: 杂志文章

    doi:10.1097/SAP.0000000000001600

    authors: Sezgin B,Guney K,Lazoglu I,Tatar S,Layegh E,Ozel M,Ozmen S,Yavuzer R

    更新日期:2019-04-01 00:00:00