Color-Flow Duplex Scanning in the Preoperative Assessment of TRAM Flap Perforators

Rand, Richard P.; Cramer, Maarten-Jan M.; Strandness, D. Eugene

doi:10.1097/00006534-199403000-00001

Cited by 47 publications

(60 citation statements)

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“…Although other techniques to preoperatively detect perforators are available (magnetic resonance imaging (Ahn et al, 1994), thermography (Chijiwa et al, 2000), and color-flow duplex scanning (Rand et al, 1994)), Hallock (1994) concludes that Doppler ultrasonography remains the most convenient, inexpensive, and readily available method for evaluating potential donor sites of perforator vessels.…”

Section: Discussionmentioning

confidence: 99%

The number of intercostal artery perforators over the distal latissimus dorsi muscle

Beer

Manestar

2010

Clinical Anatomy

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With the increasing popularity of perforator flaps as "musculocutaneous flaps without muscle," a new interest in the intercostal vessels as source vessels for perforator flaps has arisen. In a recent study, the branches of the three lowermost intercostal vessels to the latissimus dorsi were studied in detail. Now that these muscular branches are well understood, the present study examines how many of these branches reach the overlying skin as musculocutaneous perforators. We identified the intercostal artery perforators in the ninth, tenth, and eleventh interspaces, in 42 hemithoraces. Only branches that measured 0.5 mm or more in external diameter were included. The course of the perforators was followed from their exit from the latissimus dorsi muscle up to the entrance at the undersurface of the skin. This entrance point was punctured by a pin and thus marked on the skin. This study showed that at least three musculocutaneous perforators were present over the intercostal spaces IX-XI in every dorsal hemithorax (average 8 +/- 3, range 3-16). Potentially, each of these vessels can be used as a pedicle for a separate perforator flap, leaving the more proximal parts of the latissimus dorsi intact for a second flap based on the dominant thoracodorsal vessels.

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Section: Discussionmentioning

confidence: 99%

The number of intercostal artery perforators over the distal latissimus dorsi muscle

Beer

Manestar

2010

Clinical Anatomy

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“…Duplex imaging was done as previously described, 8,9 the patient was examined supine, and a Siemens Sonoline VERSA PRO apparatus (Siemens, Munich, Germany) was used.…”

Section: Operative Techniquementioning

confidence: 99%

Perforator-Sparing Abdominoplasty Technique in the Presence of Bilateral Subcostal Scars after Gastric Bypass

et al. 2007

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Background: The number of patients after gastric bypass being referred to plastic surgery units for secondary plastic surgery procedures is increasing. The characteristic abdominal deformity includes a draping apron of panniculus, occasionally associated with previous transverse surgical scars in the upper abdomen. Often a limited abdominoplasty of the low transverse type with limited undermining only up to the level of the umbilicus is performed in order not to compromise blood supply in the zone between the old transverse and the new transverse scar.Method: We propose a new, modified and safe surgical technique to perform a complete abdominoplasty with wide undermining up to the xiphoid process in patients with preexisting transverse subcostal scars after gastric bypass surgery, by selectively dissecting and preserving one to three periumbilical abdominal wall perforator vessels to secure flap blood supply. Vessel tunnelling through the rectus sheath and muscle and ligation of the cephalad branch of the perforator provide sufficient flap mobility without perforator tension or traction. Flap undermining is performed around these perforator vessels. To match dissected flap perforators with blood-flow, we performed postoperative color-flow duplex scanning.Results: We treated two patients according to this new technique. In both cases the postoperative course was uneventful and a good aesthetic result was achieved.Conclusion: We conclude from our experience that with this perforator-sparing abdominoplasty technique, safe and complete abdominoplasty can be performed with no additional risk of complications and that a good cosmetic result can be achieved in patients after open gastric bypass surgery.

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“…The technique has also been used to localize perforators in TRAM flaps (21,124), to precisely localize the pedicle of musculocutaneous gluteus maximus flaps (124) and to monitor the patency of microanastomoses in a microvascular fibula flap (157).…”

Section: Doppler Ultrasoundmentioning

confidence: 99%

“…Colour Doppler ultrasound, a technique used during the last few years to study free flaps, offers a non-invasive method to monitor the blood flow in flaps before, during and after operations (6,21,46,124). Salmi and coworkers used colour Doppler ultrasound retrospectively.…”

Section: Pre-and Postoperative Blood Flow In Free Flaps and The Recipmentioning

confidence: 99%

Blood flow in free micro-vascular flaps

Lorenzetti¹,

Salmi²,

Tukiainen³

et al. 1998

Pathophysiology

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Color-Flow Duplex Scanning in the Preoperative Assessment of TRAM Flap Perforators

Cited by 47 publications

References 0 publications

The number of intercostal artery perforators over the distal latissimus dorsi muscle

The number of intercostal artery perforators over the distal latissimus dorsi muscle

Perforator-Sparing Abdominoplasty Technique in the Presence of Bilateral Subcostal Scars after Gastric Bypass

Blood flow in free micro-vascular flaps

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