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J Reconstr Microsurg 2022; 38(03): 217-220
DOI: 10.1055/s-0041-1736317
Review Article

Superficial Circumflex Iliac Artery Perforator Flap Elevation Using Preoperative High-Resolution Ultrasonography for Vessel Mapping and Flap Design

Hidehiko Yoshimatsu
1   Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
,
Ryo Karakawa 
1   Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
,
Yuma Fuse 
1   Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
,
Akitatsu Hayashi
2   Lymphedema Center, Kameda Medical Center, Chiba, Japan
,
Tomoyuki Yano 
1   Department of Plastic and Reconstructive Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
› Author Affiliations Funding None.
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Abstract

Background The superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has gained acceptance among reconstructive microsurgeons, the minimal donor site morbidity being its greatest advantage. The purpose of this article is to introduce the use of preoperative ultrasonography to facilitate elevation and to avoid postoperative complications of the SCIP flap.

Methods Preoperative mapping of the SCIA and the superficial circumflex iliac vein (SCIV) using a high-resolution ultrasound system were performed in patients undergoing reconstruction using a free SCIP flap. The skin paddle was designed placing the SCIA and the SCIV in the middle of the flap.

Results Preoperatively marked SCIA and SCIV were found intraoperatively in all cases. The skin paddle design for sufficient arterial inflow and venous drainage resulted in no postoperative flap complications.

Conclusion The use of a preoperative high-resolution ultrasound system significantly facilitates elevation of the SCIP flap, notably via the following 2 points: 1) pedicle can always be found under the markings made with preoperative ultrasonography, 2) satisfactory perfusion of the flap can be guaranteed via a safe flap design that includes preoperatively marked vessels within the skin paddle.

Keywords

ultrasonography - superficial circumflex iliac perforator flap - flap design

Ethics

This report was published with the consent and permission of the patients involved.




Publication History

Received: 22 June 2021

Accepted: 27 August 2021

Article published online:
23 October 2021

© 2021. Thieme. All rights reserved.

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