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Updated: Mar 8, 2026

An Experimental Human DIEP Flap Model to Investigate Preservation Strategies for Vascularized Composite Allografts and Free Flaps
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TRIDIMENSIONAL DOPPLER ASSESSMENT: A RELIABLE, NON-INVASIVE AND COST-EFFECTIVE METHOD FOR PREOPERATIVE PERFORATOR

L Dražan, G A G Lombardo

    Acta Chirurgiae Plasticae
    |January 13, 2017
    PubMed
    Summary

    Handheld Doppler (HHD) examination is a valuable tool for preoperative perforator mapping in autologous breast reconstruction. This study provides a standardized method to improve the reliability of HHD in locating perforators for DIEAP flaps.

    Keywords:
    DIEPPerforator flappreoperative perforator detection autologous breast reconstruction.ultrasonography Doppler

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    Area of Science:

    • Plastic Surgery
    • Surgical Navigation
    • Medical Imaging

    Background:

    • Preoperative perforator mapping is crucial for safe and predictable autologous breast reconstruction.
    • While newer imaging like CTA is more accurate, Doppler ultrasound remains clinically relevant.
    • This paper focuses on optimizing Doppler examination for DIEAP flap perforator identification.

    Purpose of the Study:

    • To provide guidance on performing Doppler examinations for preoperative DIEAP flap evaluation.
    • To enhance the reliability of Doppler ultrasound in locating perforators.

    Main Methods:

    • A standardized Doppler examination protocol was applied preoperatively to 26 patients.
    • A Cartesian coordinate system was used to evaluate the correlation between Doppler findings and intraoperative results.

    Main Results:

    • 145 perforators were mapped in 26 patients (average 5.6 per patient).
    • 80 perforators (55.17%) were within 1 cm, and 36 (24.82%) within 2 cm.
    • A 16.55% false positive rate was observed.

    Conclusions:

    • Handheld Doppler (HHD) is a useful tool for autologous reconstruction despite limitations compared to CTA/MRA.
    • A standardized and reproducible method is recommended to increase HHD reliability.
    • This technique aids in safer, more predictable, and time-saving flap elevation.