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European Journal of Plastic Surgery
Published in: European Journal of Plastic Surgery 5/2018

Open Access 01-10-2018 | Review

Color Doppler ultrasonography targeted reconstruction using pedicled perforator flaps—a systematic review and meta-analysis

Authors: Rami Mossad Ibrahim, Gudjon Leifur Gunnarsson, Javed Akram, Jens Ahm Sørensen, Jørn Bo Thomsen

Published in: European Journal of Plastic Surgery | Issue 5/2018

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Abstract

Background

Flaps are increasingly popularized in reconstructive surgery and there is need to test and increase their reliability. Color Doppler ultrasound has been stated to be valuable in flap planning. The aim of this study was to conduct a systematic review and meta-analysis of the literature of Color Doppler ultrasound targeted pedicled perforator flaps and provide information on outcomes and complication rates.

Method

A systematic review and meta-analysis were conducted for articles published until April 2017 in PubMed and Embase. We aimed to include randomized clinical trials, meta-analysis, prospective studies, case-control studies, and cohort studies written in English. We included studies where CDU was used to identify the perforator(s) prior to surgery. We evaluated the quality of the included studies using checklists recommended by the Cochrane group.

Results

From the initial 219 studies, only 12 studies using Color Doppler targeted pedicled perforator flaps in 252 cases met the inclusion and exclusion criteria. Eleven of these were case series and one a prospective study. The incidence of major complications was 8% (21/252) and minor complications was 14%, comprising of mostly necrosis 8% (24/252) and venous congestion 8% (21/252).

Conclusions

The reconstructive success rate following pedicled perforator flap reconstruction targeted by CDU appears to be high and the procedure provides a wide scope of applications and margin of safety. It is evident that the risk of venous congestion is 11 times greater in the lower extremities than the truncus, a finding that needs further attention in future studies.
Level of Evidence: Level IV, risk/prognostic study
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Metadata
Title
Color Doppler ultrasonography targeted reconstruction using pedicled perforator flaps—a systematic review and meta-analysis
Authors
Rami Mossad Ibrahim
Gudjon Leifur Gunnarsson
Javed Akram
Jens Ahm Sørensen
Jørn Bo Thomsen
Publication date
01-10-2018
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Plastic Surgery / Issue 5/2018
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-018-1435-y

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