Designing Perforator Flaps using Ultrasound

Microsurgeons have today the freedom of the “chosen flap”, as opposed to the the “flap of choice”, but the preoperative knowledge of the microanatomy of each patient is mandatory. The needing of preoperative evaluation the perforators, not only in terms of position, but also for dimensions, flow, and relationship with the sorrounding structures became essential and allows more personalized reconstruction, less invasiveness, more safety and finally increase microsurgeon creativity. Ultrasound represents an almost essential armamentarium in the hand of the microsurgeon as it allows a in-depth preoperative evaluation of flap donor-site and a precise planning based on perforator features, including the harvesting of thin, superthin and pureskin perforator flaps.