Hemodynamic changes of peroneal perforator flaps and their clinical significance

Abstract

Objective To determine the blood flow velocity of peroneal artery perforator flaps and the related clinical significance.Methods Peak systolic flow velocity (PSFV) of 38 peroneal artery perforator flaps were measured with color doppler flow imaging (CDFI) before and after flap surgery.Flap design and surgical points were summarized in combination with correlation factors affecting vascular supply and survival of perforator flaps and clinical data.Results All flaps survived.PSFV of the supplying skin perforators was (24.68± 15.15) cm/s preoperatively and (38.65± 16.96) cm/s postoperatively.There were 12 free perforator flaps with significant increase in PSFV after operation in comparison with that before operation [(32.69± 15.86) cm/s vs (14.19±6.28) cm/s,P＜0.01].Pedicled perforator flaps amounted to 26 and PSFV significantly increased from preoperative (29.52± 15.65)cm/s to postoperative (41.40± 17.04)cm/s (P＜0.01).Conclusion The vessel pedicles should be dissected thoroughly and all irrelevant branches arising from them should be ligated to gain maximal flow through the perforator.The phenomenon of crossing angiosomes of the flap' s blood supply especially through the long and low-resistant neurocutaneous vascular axis can be explained from a hemodynamic view. Key words: Soft tissue injuries; Hemodynamics; Perforator flaps