The Clinical Research Of The Portable Ultrasonic Doppler For The Perforator Vessels Locating In Perforator Flap With Descending Branch Of The Lateral Circumflex Femoral Arter

Objective: By using Portable ultrasonic Doppler(PUD)to detect and locate the position and number of the perforator vessels in perforator flap with descending branch of the lateral circumflex femoral arter,and to verify in intraoperative,to provide the basis for the design of small and medium-sized flap and polyfoliate perforator flap with descending branch of the lateral circumflex femoral arter.Methods: Thirty patients were treated with surgery of the perforator flap with descending branch of the lateral circumflex femoral arter in our hospital from January 2016 to January 2017.the site of perforating vessel on the body surface was determined by the PUD blood flow detector(Hadeco Es-1000SPM(8MHz))and marked.Hemodynamic waveforms were printed,with hemodynamic waveform amplitudes corresponding to each perforator measured and recorded and mean values obtained.To calculate and record the body mass index(BMI).Intraoperatively,the number of perforator vessels and location were observed and recorded;The preoperative orientation situation was compared to the actual situation in the operation;Statistical correlation analysis was conducted between preoperative mean waveform amplitudes in PUD and BMI.Results:(1)Among the 30 patients,the number of perforators determined by the PUD blood flow detector preoperatively was 66,the intraoperative number of perforators was 82,with 52 accurately localized in preoperative and intraoperative examination,with 16 were undetected before the operation,respectively,The number of Preoperative examination and intraoperative detection location differs from above 5 mm was 14,the distance between 6 and 20 mm,there are 8 branches,and over 20 mm there are 6,The positive predictive value and sensitivity of the PUD blood flow detector in the localization of perforators was78.79% and 63.41%,(2)Statistical correlation analysis between preoperative mean waveform amplitudes of perforator vessels in the PUD and the BMI indicated a inpositive correlation,presenting statistical significance(r =-0.746,P <0.05).Conclusion: Portable ultrasonic Doppler can accurately locate the perforator vessels of perforator flap with descending branch of the lateral circumflex femoral arter.It can provide a reference for the design of the small and medium-sized flap and polyfoliate perforator flap with descending branch of the lateral circumflex femora larter.