Shuhei Yoshida1*, Isao Koshima1, Hirofumi Imai1, Toshio Uchiki2, Ayano Sasaki2, Yumio Fujioka2, Shogo Nagamatsu2, Kazunori Yokota2, Shuji Yamashita3 and Kensuke Tashiro4
1The International Center for Lymphedema, Hiroshima University Hospital, Japan
2Plastic and Reconstructive Surgery, Hiroshima University, Japan
3Plastic and Reconstructive Surgery, Tokyo University, Japan
4Department of Plastic and Reconstructive Surgery, Jichi Medical University, Japan
applications of supermicrosurgery. However, we often encounter poor pulsation and spurting of blood from a recipient perforator intraoperatively, which makes it impossible to perform perforatorto- perforator anastomosis. The aim of this study was to identify color Doppler US parameters that can aid reliable preoperative selection of a recipient perforator artery by comparing the preoperative examination data with direct observation of the perforators intraoperatively. Patients and Methods: The study included 38 patients who underwent vascularized lymphatic tissue transfer. In all cases, we searched for perforators in the lower extremities using color Doppler US on the day before surgery. The vessel diameter at maximal pulsation, peak systolic flow velocity, and depth of each perforator were recorded. As one of the direct observation data, each perforator detected was divided into 4 categories according to the depths of dissection steps required until confirming sufficient pulsation or blood flow. Results: The correlation between the preoperative peak systolic flow velocity in the perforator and completion of the steps for successful perforator dissection was statistically significant (p<0.01). The correlation between preoperative depth where the highest peak systolic flow velocity was detected and completion of the steps for successful perforator dissection was statistically significant (p<0.01). Discussion: Both functional and morphological assessment is necessary preoperatively in order to reduce the intraoperative burden of searching for an adequate recipient perforator. We deduced from our findings that a peak systolic flow velocity of ≥ 20.0 cm/s is an important determinant of successful dissection.
Yoshida S, Koshima I, Imai H, Uchiki T, Sasaki A, Fujioka Y, et al. Relationship Between Preoperative Flow Velocity in Recipient Perforator Arteries Determined by Color Doppler Ultrasonography and Intraoperative Pulsation and Blood Spurting During Perforator-to-Perforator Anastomosis. Clin Surg. 2020; 5: 2905.