Blondeel P N, Beyens G, Verhaeghe R, Van Landuyt K, Tonnard P, Monstrey S J, Matton G
Plastic and Reconstructive Surgery, University Hospital Gent, Belgium.
Br J Plast Surg. 1998 Apr;51(3):202-9. doi: 10.1016/s0007-1226(98)80010-6.
Perforator flaps have become the first choice in free flap reconstruction of contour defects or skin and fat replacement in our department. The Deep Inferior Epigastric Perforator (DIEP), the Superior Gluteal Artery Perforator (S-GAP) and the Thoracodorsal Artery Perforator (TAP) flaps are now routinely used. By evaluating the vascular anatomy of these flaps preoperatively, we intend to improve our surgical strategy so that these operative procedures can proceed in a faster and safer way. In this study, the results of the colour Duplex scanning in 50 consecutive DIEP flap patients are reviewed and evaluated for their sensitivity and positive predictive value. Also the preoperative information from unidirectional Doppler flowmetry in 30 S-GAP flaps and 11 TAP flaps is evaluated for its reliability. Due to the variable vascular anatomy of the lower abdominal wall and the dorso-lateral thoracic wall we now prefer using the colour Duplex scanning for planning the DIEP and TAP flaps. The more constant course of the branches of the superior gluteal artery allows us to use the easier and cheaper unidirectional Doppler flowmetry for planning the S-GAP flap.
穿支皮瓣已成为我科修复轮廓缺损或进行皮肤及脂肪替代的游离皮瓣重建的首选。目前，腹壁下深动脉穿支（DIEP）皮瓣、臀上动脉穿支（S-GAP）皮瓣和胸背动脉穿支（TAP）皮瓣已常规使用。通过术前评估这些皮瓣的血管解剖结构，我们旨在改进手术策略，以使这些手术能够更快速、安全地进行。在本研究中，回顾并评估了50例连续DIEP皮瓣患者的彩色双功超声扫描结果，以确定其敏感性和阳性预测值。同时，还评估了30例S-GAP皮瓣和11例TAP皮瓣的术前单向多普勒血流仪检查信息的可靠性。由于下腹壁和胸壁背外侧的血管解剖结构存在差异，我们现在更倾向于使用彩色双功超声扫描来规划DIEP和TAP皮瓣。臀上动脉分支的走行较为恒定，这使我们能够使用更简便、便宜的单向多普勒血流仪来规划S-GAP皮瓣。
