High Resolution Imagistic Methods for Detection of Tegumentar Perforators That Can Be Used in Reconstruction Surgery of Tissue Defects. Pig Experimental Model

Abstract


 
 
 Tissue defects still determine a high surgical interest in finding new and more efficient methods of covering. Perforator flaps are considered one of the most important methods of reconstruction, for defects all over the body. Anatomists, surgeons, radiologists are fervently searching ways to improve their reliability and also strategies to ensure that the chosen flap to be used is the best for that case. It has been proven that tissue defects’ reconstruction involves knowing the exact anatomy and physiology of various vascular sources, but there are still unknown factors that sometimes induce perforator flaps failure.
 Objective: The aim of this study is to identify and evaluate by two imagistic methods the perforator vessels in an experimental model of perforator flaps in pig.
 Methods: The imagistic method employed was the X-ray angiography and Color Doppler vascular ultrasonography with high performance equipment. The explored perforators were located on the body of the experimental model, that was divided in 9 regions and the comparison was made between the perforators identified by imagistic methods and by microsurgical careful dissection.
 Results: This study revealed that the average sensibility of ultrasound per region was 52.66% and the average sensibility of angiography per region was 35.30% on the entire lot.
 Conclusion: The Color Doppler ultrasonography is a very reliable method for detection of the perforator vessels, with better results compared with X-ray angiography, detecting even the smaller perforators. So, the surgeon can rely the operative planning on this preoperative vascular exploration.