Does Preoperative Vascular Mapping Using Color-Doppler Ultrasound have a Role in the Success of Axial Nasolabial Flap?

AIM

The study was performed to compare the effects of preoperative vascular mapping on the clinical outcome of axial nasolabial flap.

MATERIALS AND METHODS

A total of 26 patients (29 flaps) were alternately divided into two groups using simple block randomization method. In Group I patients, the conventional axial flap was marked. In Group II, USG-guided flap was designed with the help of Color-Doppler ultrasound. Patients were assessed for a minimum of 6 months and the postoperative flap outcome was quantified using a self-validated composite scoring system. Other parameters of patient morbidity including length of hospital stay, resurgery for reconstruction of secondary defects, postoperative complications were also measured and compared.

RESULTS

The mean postoperative flap outcome score was significantly superior in Group II patients than Group I, at the beginning and at the conclusion of the study (intergroup -value at postoperative-1-week = .001; at postoperative-1-month = .044; at postoperative-3-month = .139; at postoperative-6-month = .007). Additionally, reconstruction defects with the conventional nasolabial flap were associated with greater morbidity as compared to Group II (intergroup comparison-hospital stay and duration  = .001; complications  = .115; Redo Surgery  = .096).

CONCLUSION

Therefore, it can be concluded that flap selection based on known dominant perforators could be helpful in achieving favorable outcomes resulting in minimal postoperative morbidity while allowing complex surgical reconstructions.