Abstract

SYLVESTER-FRIAS, Marilú; ROCO-MOLINA, Héctor  and  MERUANE-NARANJO, Manuel. Usefulness of manual doppler in planning the DIEP flap. Cir. plást. iberolatinoam. [online]. 2016, vol.42, n.4, pp.371-378. ISSN 1989-2055.

Background and Objective: There are various types of studies used in preoperative planification of the deep inferior epigastric perforating artery flap (DIEP), such as ultrasound, angio-computed tomography and magnetic resonance imaging. At our hospital we use manual doppler, but its has been questioned for being operator dependent and having lower sensitivity in perforating artery detection. We intend to clinically assess manual doppler as preoperative study for perforating inferior epigastric vessels and to estimate interoperator variability. Patients and Method: We design a cross-sectional study. Consecutive patients undergoing abdominoplasty or DIEP flap reconstruction during one year were included. Patients with previous complex abdominal surgeries were excluded. Preoperative manual doppler mapping was performed, independently, by either of 2 surgeons, one more experienced than the other. The mapping result was compared with surgical mapping. Mapping sensitivity and specificity were estimated, technical measurment error √(∑D2/2N) was used to assess the pre and intraoperative distance between perforating vessels, and the Pearson's correlation factor between operators. Results: Twenty patients were included, aged between 23 and 63 years. Sensitivity was 81.5% v/s 80% and specificity was 12.5% v/s 10% for the more and less experienced surgeons respectively. The Pearson's correlation factor for dominant perforating vessels was 0.8 between operators. The technical measurement error for dominant perforating vessels was 7.53 mm for the more experienced surgeon and 8.39 mm for the less experienced surgeon. There were no statistically significant differences between both operators. Conclusions: Manual doppler can be used, with certain limitations, in identification of inferior epigastric perforating vessels. Our study does not show significant difference between operators.

Keywords : Perforator flaps; DIEP; Mammary reconstruction; Ultrasound; Doppler.

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