Clinical Observation And Study On Arterial Flow Variation Of The Pedicled Perforator Flaps

Objective:To detect the location of the perforator passing through the deep fascia and study the arterial flow variation and diameter changes of perforator before and after the pedicled perforator flaps transposition by High frequency ultrasonography, and explore the related factors affecting the flaps survival. Based on the study,we can make clear the arterial flow variation and diameter changes of perforator before and after the pedicled perforator flaps transposition and can explore the related factors affecting the flaps survival with which we can provide reliable evidence for its clinical application and can expect a better clinical efficacy.Methods:The research recruit the pedicled perforator flaps in repairing soft tissue defect of 28 patients from April 2014 to February 2015 in our Hospital. To test the location of the perforator passing through the deep fascia on the patients by High frequency ultrasonography, and making the comparison of the observation of perforating blood vessels during the surgery. Arterial flow was recorded by High frequency ultrasonography on preoperatively, and on day 1, 2,3,5,7 and 14 postoperative. Observation and study the relation of survival of the flaps and factors affecting it.. The final results were analyzed by a computer software program for Microsoft Windows(SPSS,16.0), and a value equal to 0.05 was considered as test standard.Results:1、A increase in arteria flow was observed after operation, getting a peak value on postoperative day 5, but had a tendency of decrease after postoperative day 5, arteria flow of day 14 was still higher than the preoperative.2、The size of flap area survival is positively related to preoperative arteries flow (r=0.987, P=0.000).3、the location of the perforator passing through the deep fascia in preoperative and intraoperative seen the position accuracy of 100%. Traditional surface orientation and perforators artery draw point axis angular deviation exists. The angular deviation is 4.7°～8.5°(On average 6.5°).Conclusion:(1)The size of flap area survival is positively related to preoperative arteries flow. The change of the arterial flow is in conformity with pathological physiological changes of the flaps and have a certain guiding role to judge prognosis of the flaps. (2) High frequency ultrasonography is an accurate method to determine the location passing through the deep fascia in preoperative of perforators artery and chain axis of the perforator artery.