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CC BY-NC 4.0 · Arch Plast Surg 2015; 42(01): 78-83
DOI: 10.5999/aps.2015.42.1.78
Idea and Innovation

Preoperative Identification of a Perforator Using Computed Tomography Angiography and Metal Clip Marking in Perforator Flap Reconstruction

Jung Woo Lee
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
,
Han Kyeol Kim
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
,
Sin Rak Kim
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
,
Yea Sik Han
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
,
Jin Hyung Park
Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, Busan, Korea
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In perforator flap reconstruction, vascular mapping using preoperative computed tomography (CT) angiography is widely used to confirm the existence and location of an appropriate perforator. This study proposes a rapid, accurate, and convenient method for marking the perforator location on the skin surface. For 12 patients who underwent perforator flap reconstruction between November 2011 and November 2013, metal clips were fixed on the skin surface at the anticipated perforator locations, which were decided using a handheld Doppler. CT angiography was used to compare the location between the metal clip and the actual perforator. The metal clip was moved and repositioned, if needed, on the basis of the CT images. The locations of the appropriate perforator and the metal clip, which were observed during the surgery, were then compared. In CT angiography, the mean distance between the metal clip and the perforator was 3±3.9 mm, and the mean distance that was measured during surgery was 0.8±0.8 mm. In conclusion, we report a simple, rapid, and precise technique to indicate the accurate location of the appropriate perforator on the skin surface.

Keywords

Ultrasonography, Doppler - Multidetector computed tomography - Perforator flap


Publication History

Received: 10 February 2014

Accepted: 10 April 2014

Article published online:
05 May 2022

© 2015. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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