| Objective: The flap transfer is popularity in the field of plastic surgery. In clinical plastic surgery, Axial pattern flap is been attention along with development of clinical anatomy, because it has the credibility of blood supply, the strong ability of anti-infection and the flexible transfer. But it is key that the survived flap must be abundance blood of supply and vein of circumfluence after restoration operations. The advantage of color Doppler is unhurt, intuitionistic, continuous and convenient, and the color Doppler can be used to analyze quanuficationally continuous blood stream. The Color Doppler Flow Imaging (CDFI) and the Color Doppler Energy (CDE) were adopted to detect creatural blood vessel before operation, in order to understand the distribution of vessel in the axial pattern flaps. The examination was done, in order to assess the design of axial pattern flap, and detected continuously the change of dynamics on blood stream, which provided valuable information for plastic surgeon before operation.Methods: CDFI of high resolution of Acuson Sequoia 512 system was used in the design of axial pattern skin flap with CDE, including the vascular diameter and traveling direction and distribution, the quality of the blood vessel and its flowing dynamics were measured. AcusonSequoia 512 system was selected with blood vessel, 15L8w type of probe and superficial small part of software. The condition of apparatus: wall filter is 1-3 grade; sampling volume is 0.5-2mm, the probe of frequency is 8-13MHz, and the sound beam-flow angle is < 60 . The color blood stream velocity areas are 10-100cm/s (deep arterial trunk) and 5-50cm/s (cutaneous arterial branches). Acuson Squoia 512 and ultrasound Doppler flow imaging meter were used to detect two dimensional color flow distribution characteristics of arteries and veins, as well as the rotatory scapular arterin and veins, so as to check out the starting and ending point, length and direction of blood vessels in the axial pattern skin flap and rotatory scapular skin flap area. According as blood vessel and superficial small part of software in Acuson Sequoia 512 system, many kinds of parameters were calculated such as Vmax, Vmin, Vmean, RI, S/D, and CO, so that the quality of blood vessel can be understood. Results:I . According as the demand on the place of trauma, CDFI of high resolution of Acuson Sequoia 512 system and CDE were used to detect 20 patients for pre-operation, including the vascular diameter and traveling direction and distribution, the quality of the blood vessel and its flowing dynamics were measured. The results were 20 (deep arterial trunk) and 60 (cutaneous arterial branches). (1) By two dimensional echo (2DE), the arterial trunk and branches were detected that the vascular traveling direction and distribution were well-balanced, their wall were slippery without absentphenomena, fleckiness, incrassated velum and thrombus, and the blood flowed rapidly in their cavity. (2) The Pulsed Wave Doppler (PWD) was used to detect the characteristics of arterial trunk and branches that were laminar flow, narrowband velocity, and incomplete fill. Many kinds of parameters were obtained such as Vmax, Vmin, Vmean, RI, S/D, and CO by PWD.II. CDFI was adopted to examine the lateral thoracic island skin flap and the scapular island skin flap. Compared with the condition before operation, the two dimensional color flow distribution and hemodynamical change in the flap have changed with characteristics as below:(1) 2-24h after operation, inner diameter of arteries and veins in the flap decreased, flow signals were detected in all the parts of flap, the number and density of blood vessel decreased progressively, however, Vmax, Vmean and RI were slightly higher than the level before operation, PI was slightly declined, while Vmain, S/D hadn't changed obviously.(2) 1, 3, 5, 7d after the operation, inner diameter of axis arteries in the flap area expand obviously. Number and density of blood vessel increased, Vmax, Vmean, and Vmin were ob... |
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