POWER DOPPLER IMAGING IN PREOPERATIVE PLANNING AND POSTOPERATIVE MONITORING OF MUSCLE FLAPS

Purpose. We assessed the utility of power Doppler imaging (PDI) in pre operative planning and postoperative evaluation of microvascular tissu e transfers. Methods. Twenty-five PDI studies were performed on 23 pat ients using a 5-10-MHz linear-array transducer. Thirteen patients were assessed preoperatively for patency of the desired donor vessel; 8 of them had surgical scars overlying the desired vascular territory. Twe lve patients (including 2 from the first group) were evaluated postope ratively for patency of the vascular anastomoses and adequacy of the b lood supply to the transferred tissue. Results. Twelve of the 13 patie nts assessed preoperatively had successful flap transfers. Four of the 8 patients with scars over the desired vascular territories had absen t or aberrant arteries, necessitating a change in the operative plan. None of these patients had operative complications. Eight of the 12 pa tients scanned postoperatively had patent anastomoses. In 2 of these p atients, impending surgery was averted when the adequacy of the tissue blood supply was established with PDI. In 4 patients, PDI showed arte rial or venous compromise, which was confirmed at surgery. Conclusions . PDI is a useful technique in microsurgical tissue transfer for asses sing the patency of desired donor vessels preoperatively and for posto perative evaluation of blood supply. (C) 1997 John Wiley & Sons, Inc.