[A survey of preoperative perforator mapping in perforator flap surgery].
BACKGROUND
The frequency of perforator flap surgery is increasing. As such, the claim to identify and localize the perforators is closely related to preoperative perforator imaging. Starting with Doppler sonography magnetic resonance imaging (MRI) followed early in the 90s. Recently, three- and four-dimensional computer tomographic angiography and venography present impressive preoperative illustrations of perforators.


OBJECTIVE
Duplex ultrasound dominates in clinical practice for perforator imaging.


METHODS
We performed a survey using a multiple choice questionnaire which was distributed among consultants of the German plastic surgery society (DGPRAC). Response rate was 46% with 132 institutions responding.


RESULTS
Preoperative perforator imaging is applied in 77%. Duplex sonography is predominant with 70%, followed by colour Doppler ultrasound (42%). CT angiography (7%) and MRI angiography (8%) are currently underutilized. The amount of perforator flaps performed did not favor any preoperative perforator diagnostic. However, among those performing more than 30 perforator flaps per year, only 2% did not perform any perforator diagnostic at all.


CONCLUSIONS
Preoperative perforator imaging is applied in 3/4 of all perforator flaps with duplex ultrasound dominating. Angio-CT and Angio-MRI are currently infrequently used for preoperative perforator imaging in Germany to date.
Knobloch
K
K
Medizinische Hochschule Hannover, Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Hannover. knobloch.karsten@mh-hannover.de
Reuss
E
E
Gohritz
A
A
Redeker
J
J
Vogt
P M
PM
D000792:Angiography / Q000706:statistics & numerical data; D003625:Data Collection; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000706:statistics & numerical data; D008866:Microsurgery / Q000379:methods*; D011300:Preoperative Care; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D012955:Societies, Medical; D013524:Surgical Flaps / Q000098:blood supply*; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D018615:Ultrasonography, Doppler, Color / Q000706:statistics & numerical data; D014600:Utilization Review / Q000706:statistics & numerical data