Ultrasound in reconstructive microsurgery: (CONSULTANT-LEVEL EXAMINATION)

Overview

Recent innovations in local tissue rearrangement and free tissue transfer have altered surgical approaches from simple wound care or amputation to optimal functional and aesthetic repair. Survival of transferred tissue remains a concern in trauma patients. ^, Apart from the surgical technique, various factors may influence microsurgical operations, such as defect location and size, functional characteristics and underlying disorders, types of affected tissue, anatomic variants, and the presence of trauma or infection. The surgical focus is underlined by an effort to maximize the functional and aesthetic results, although safety remains a paramount requirement. Careful preoperative design, decision-making, and postoperative management in the intensive care unit (ICU) are as critical as the operation itself. Designing reconstructive microsurgical operations is challenging and cannot rely solely on clinical criteria. Ultrasound has been used to study blood flow in free flaps by means of implantable Doppler probes or by surface scanning with high-frequency transducers. Ultrasound techniques have increasingly been assimilated in surgical planning of flaps during the last decade.