Handchir Mikrochir Plast Chir 2011; 43(2): 71-75
DOI: 10.1055/s-0030-1255071
Originalarbeit

© Georg Thieme Verlag KG Stuttgart · New York

Doppler-Sonografie und Farbdopplersonografie zur präoperativen Perforatordarstellung beim anterolateralen Oberschenkellappen

Doppler Sonography and Colour Doppler Sonography in the Preoperative Assessment of Anterolateral Thigh Flap PerforatorsF. Ensat1 , M. Babl1 , C. Conz1 , B. Fichtl2 , G. Herzog2 , M. Spies1
  • 1Krankenhaus Barmherzige Brüder Regensburg, Klinik für Plastische, Hand-, und Wiederherstellende Chirurgie, Regensburg
  • 2Krankenhaus Barmherzige Brüder Regensburg, Klinik für Innere Medizin I, Regensburg
Further Information

Publication History

eingereicht 3.3.2010

akzeptiert 27.5.2010

Publication Date:
05 July 2010 (online)

Zusammenfassung

Hintergrund: Der anterolaterale Oberschenkellappen hat in den letzten Jahren zunehmend Verwendung in der rekonstruktiven Mikrochirurgie der Kopf-Hals Region und der Extremitäten gefunden. Als einer der Nachteile des Lappens wird häufig die variable Anatomie der Perforatoren genannt, weshalb verschiedene bildgebende Verfahren zur präoperativen Darstellung der Perforansgefäße verwendet werden.

Material und Methoden: In dieser Arbeit wurde die Verlässlichkeit der Doppler- und Farbdopplersonografie zu diesem Zweck bei insgesamt 14 Patienten untersucht.

Ergebnisse: Dabei konnten mittels Farbdopplersonografie 29 Perforatoren identifiziert werden, welche sich intraoperativ alle bestätigten. Es traten 2 falsch negative Ergebnisse auf. Bei der Dopplersonografie fanden sich bei 25 richtig positiven Signalen 11 falsch positive und 6 falsch negative Ergebnisse.

Schlussfolgerung: Beide Verfahren stellen unkomplizierte und rasche Methoden zur Perforatorlokalisation beim ALT dar, wobei die Verlässlichkeit der Farbdopplersonografie im direkten Vergleich eindeutig höher ist, was eine exakte Lappenplanung um präoperativ dargestellte Perforatoren ermöglicht.

Abstract

Background: In the past years the anterolateral thigh flap has become a workhorse flap in the reconstruction of the head and neck region and the extremities. Due to its variable vascular anatomy the preoperative assessment of perforators has been performed using several devices.

Patients and Methods: In our study we investigated the reliability of Doppler sonography and colour Doppler sonography for this purpose in 14 patients undergoing reconstruction with anterolateral thigh flaps. Colour Doppler sonography identified 31 perforators preoperatively, which were all identified during flap harvest. Doppler sonography found 25 true positive signals, 11 false positive signals and 6 false negative signals.

Conclusions: Both procedures provide a simple and rapid method for the localisation of ALT perforators. However, colour Doppler sonography showed a significantly higher reliability in identifying perforators of anterolateral thigh flaps, thus enabling flap design around preoperatively confirmed perforators.

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Korrespondenzadresse

Dr. Florian Ensat

Krankenhaus Barmherzige

Brüder Regensburg

Klinik für Plastische,

Hand-, und Wiederherstellende

Chirurgie

Prüfeningerstraße 86

93049 Regensburg

Email: florian.ensat@barmherzige-regensburg.de

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