Diagnostic Accuracy of Peroperative Color Doppler Ultrasonography for Determining the Nature of Anterolateral Thigh Flap Perforators

Abstract

Objective: To determine the diagnostic accuracy of color Doppler ultrasonography for diagnosing septocutaneous nature of anterolateral thigh flap perforators taking peroperative findings as gold standard among patients undergoing soft tissue reconstruction.

Methodology: A total number of 100 patients undergoing soft tissue reconstruction using antero-lateral thigh flap perforators at plastic surgery unit, Pak Italian Modern Burn Center, Multan and fulfilling the selection criteria were approached. An informed consent were taken from them before enrolling in the study. Information regarding their demographic data were noted in the proforma. A high frequency color Doppler ultrasound was done by the consultant radiologist to determine the nature of the perforator (as per operational defination) and the results were noted in the proforma. The anterolateral thigh thin flap was undermined, but kept in situ. The elevation was performed either on superficial or sub-facial plane depending upon situation and surgical plan, and the points of emergence through the deep fascia and nature of its perforators, as they appeared during surgery, was noted in the proforma.

Results: Age distribution of the patients was done, it showed that out of 100 patients, 17 %( n=17) were in age group of 15-27 years and 83%( n=83) were in age group of 28-40 years and  mean age was calculated as 33.96±5.72 years. Gender distribution of the patients was done, it showed that 88 %( n=88) were male whereas 12 %( n=12) were females. In this study, Sensitivity and specifity of septocutaneous nature of perforator was 78.41% and 83.33% respectively and PPV was 97.18% and NPV was 34.48% and  accuracy was 79%.

Conclusion: Color doppler ultrasonography is the reliable test for the prediction of nature of anterolateral thigh flap perforator.