DOPPLER FLOWMETRY IN THE PLANNING OF PERFORATOR FLAPS

Perforator flaps have become the first choice in free flap reconstruct ion of contour defects or skin and fat replacement in our department. The Deep Inferior Epigastric Perforator (DIEP), the Superior Gluteal A rtery Perforator (S-GAP) and the Thoracodorsal Artery Perforator (TAP) flaps are now routinely used. By evaluating the vascular anatomy of t hese flaps preoperatively, we intend to improve our surgical strategy so that these operative procedures can proceed in a faster and safer w ay. In this study, the results of the colour Duplex scanning in 50 con secutive DIEP flap patients are reviewed and evaluated for their sensi tivity and positive predictive value. Also the preoperative informatio n from unidirectional Doppler flowmetry in 30 S-GAP flaps and 11 TAP f laps is evaluated for its reliability. Due to the variable vascular an atomy of the lower abdominal wall and the dorso-lateral thoracic wail we now prefer using the colour Duplex scanning for planning the DIEP a nd TAP flaps. The more constant course of the branches of the superior gluteal artery allows us to use the easier and cheaper unidirectional Doppler flowmetry for planning the S-GAP flap.