Abstract
Background During elevation of the superficial circumflex iliac artery (SCIA) perforator (SCIP)
flaps, the flap pedicle must often be converted from the superficial branch to the
deep branch of the SCIA, complicating and prolonging the procedure. The goal of the
present study was to demonstrate the effectiveness of high-resolution ultrasonography
to decrease the conversion rate on which no previous report has focused, by making
a comparison with a conventional method.
Methods Forty-five consecutive cases where free SCIP flap transfer was performed for reconstruction
were retrospectively reviewed. To preoperatively mark the course of the superficial
branch, handheld Doppler ultrasonography was used in 27 cases (group 1) and a high-resolution
ultrasound system in 18 cases (group 2).
Results The conversion rate was significantly greater in group 1 than in group 2 (10/27 [37%]
vs. 0/18 [0%], p = 0.003]. The frequency of use of multiple venous anastomoses was significantly higher
in group 1 than in group 2 (21/27 [78%] vs. 2/18 [11%], p < 0.001). The operative time was significantly longer in group 1 than in group 2
(p = 0.038). There were no significant differences in postoperative complication rates
(1/27 [4%] versus 0/18 [0%], p = 1.0).
Conclusion The use of a preoperative high-resolution ultrasound system significantly decreased
the rate from of intraoperative conversion from the superficial branch to the deep
branch of the SCIA. It also resulted in significantly fewer venous anastomoses and
a shorter operative time, while maintaining a low incidence of postoperative complications.
Keywords
ultrasonography - superficial circumflex iliac artery perforator flap - superficial
branch of the superficial circumflex iliac artery
