Abstract
Background
This study investigates the impact of preoperative ultrasound mapping using color
Doppler ultrasound (CDU) on surgical outcomes for anterolateral thigh (ALT) free flap
reconstructions.
Methods
A retrospective review was conducted on patients who were diagnosed with cancer and
underwent ALT free flap reconstruction. Patients were grouped based on the use of
either computed tomography angiography (CTA) with a handheld Doppler (HHD) or CDU
for preoperative planning. Patient demographics, operation times, flap elevation durations,
and postoperative outcomes were evaluated.
Results
A total of 63 patients were included in this study (23 in the CTA + HHD group and
40 in the CDU group). Preoperative CDU planning was associated with a significantly
shorter total operation time (214 vs. 252 minutes, p = 0.05) compared with conventional imaging. The CDU group also demonstrated significantly
lower rates of revision surgery (p = 0.006), total flap loss (p = 0.05), and partial flap loss (p = 0.05). In multivariate linear regression analysis, CDU use was the only factor
independently associated with shorter flap elevation time (p = 0.04) among the evaluated surgical variables.
Conclusion
The findings suggest that incorporating preoperative ultrasound mapping enhances surgical
outcomes by optimizing flap elevation and reducing complications. The use of CDU proves
valuable in achieving better preoperative planning, leading to improved efficiency
and overall success in reconstructive surgeries using ALT free flaps.
Keywords
ultrasound - free flap - cancer
