Abstract
Background With the technological advances, microsurgery has evolved to the era of supermicrosurgery
since its inception. With the popularization of these flaps, proficiency in using
tools such as color Doppler ultrasound (CDU) has become crucial. Despite the increased
interest, studies regarding the role of ultrasound in microsurgical reconstruction
are scarce. Therefore, in this study, we discussed currently available imaging modalities
for reconstructive surgeons, types of ultrasound, and the role of ultrasound in microsurgical
reconstruction, and made recommendations for ultrasound use in reconstructive surgery.
Methods We performed a computerized search of ultrasound in reconstructive surgery using
the MEDLINE database. Data regarding ultrasound indications, usage, and outcomes were
collected.
Results Of the 115 articles identified, the majority was written on nonreconstructive ultrasound
uses (51.4%). For the reconstructive uses, mapping of perforators was the most common
usage (39.1%), followed by flap monitoring and volume measurement. In addition, we
found that there are a limited number of literature on the role of CDU in reconstructive
surgery, especially on its intraoperative and postoperative use.
Conclusion CDU is a valuable and powerful tool for any reconstructive surgeons who are interested
in performing microsurgery or supermicrosurgery. As the demand of customized flaps
using superthin flaps, perforator-to-perforator anastomosis, and supermicrosurgery
increases, understanding and becoming versatile in CDU will be critical. We hope our
experience with using ultrasound and refinements that we made are helpful for those
who would like to include it as a part of their armamentarium.
Keywords
color Doppler ultrasound - duplex - supermicrosurgery - microsurgery - imaging
