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Illg C, Krauss S, Rachunek K, Hoffmann S, Denzinger M, Kolbenschlag J, Daigeler A, Schäfer RC. Does leg dominance influence anterolateral thigh flap perforators? Microsurgery 2022; 42:817-823. [PMID: 36200703 DOI: 10.1002/micr.30968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/20/2022] [Accepted: 09/19/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Thorough knowledge of perforator anatomy can facilitate anterolateral thigh (ALT) free flap harvest. The selection of the right or left thigh as donor area may be supported by preoperative perforator imaging and practical considerations. The study aims to determine if the leg dominance should be taken into account, when choosing the donor thigh for ALT free flap harvest, as muscle mass and perfusion might influence perforator quantity. METHODS ALT perforators were localized by color-coded duplex sonography and dynamic infrared thermography on both thighs within a defined 250 × 80 mm area in 24 subjects. Perforator number and thickness of subcutaneous tissue and muscle layer were compared in dominant and nondominant legs. RESULTS We found no statistically significant difference comparing sonographically identified ALT perforator numbers and hot spot numbers in dominant and nondominant legs. Yet, we found high interindividual differences. The comparison of subcutaneous tissue and muscle thickness yielded no significant difference. CONCLUSIONS Our study yielded no evidence for preference of the dominant or nondominant leg in ALT free flap harvesting. As we found high interindividual differences in perforator number, we suggest to rely on preoperative perforator imaging when choosing the ALT free flap donor thigh.
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Affiliation(s)
- Claudius Illg
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University, Tuebingen, Germany
| | - Sabrina Krauss
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University, Tuebingen, Germany
| | - Katarzyna Rachunek
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University, Tuebingen, Germany
| | - Sebastian Hoffmann
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University, Tuebingen, Germany
| | - Markus Denzinger
- Department of Pediatric Surgery, University Medical Center, Regensburg, Germany
| | - Jonas Kolbenschlag
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University, Tuebingen, Germany
| | - Adrien Daigeler
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University, Tuebingen, Germany
| | - Ruth Christine Schäfer
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University, Tuebingen, Germany
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Becker AB, Chen L, Ning B, Hu S, Hossack JA, Klibanov AL, Annex BH, French BA. Contrast-Enhanced Ultrasound Reveals Partial Perfusion Recovery After Hindlimb Ischemia as Opposed to Full Recovery by Laser Doppler Perfusion Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:1058-1069. [PMID: 35287996 PMCID: PMC9872654 DOI: 10.1016/j.ultrasmedbio.2022.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 06/03/2023]
Abstract
Mouse models are critical in developing new therapeutic approaches to treat peripheral arterial disease (PAD). Despite decades of research and numerous clinical trials, the efficacy of available therapies is limited. This may suggest shortcomings in our current animal models and/or methods of assessment. We evaluated perfusion measurement methods in a mouse model of PAD by comparing laser Doppler perfusion imaging (LDPI, the most common technique), contrast-enhanced ultrasound (CEUS, an emerging technique) and fluorescent microspheres (conventional standard). Mice undergoing a femoral artery ligation were assessed by LDPI and CEUS at baseline and 1, 4, 7, 14, 28, 60, 90 and 150 d post-surgery to evaluate perfusion recovery in the ischemic hindlimb. Fourteen days after surgery, additional mice were measured with fluorescent microspheres, LDPI, and CEUS. LDPI and CEUS resulted in broadly similar trends of perfusion recovery until 7 d post-surgery. However, by day 14, LDPI indicated full recovery of perfusion, whereas CEUS indicated ∼50% recovery, which failed to improve even after 5 mo. In agreement with the CEUS results, fluorescent microspheres at day 14 post-surgery confirmed that perfusion recovery was incomplete. Histopathology and photoacoustic microscopy provided further evidence of sustained vascular abnormalities.
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Affiliation(s)
- Alyssa B Becker
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Lanlin Chen
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Bo Ning
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Song Hu
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - John A Hossack
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Alexander L Klibanov
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA; Department of Medicine, Cardiovascular Division, University of Virginia, Charlottesville, Virginia, USA
| | - Brian H Annex
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA; Department of Medicine, Cardiovascular Division, University of Virginia, Charlottesville, Virginia, USA
| | - Brent A French
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA; Department of Medicine, Cardiovascular Division, University of Virginia, Charlottesville, Virginia, USA.
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Lower Limb Perfusion Asymmetries in Humans at Rest and Following Activity—A Collective View. Symmetry (Basel) 2021. [DOI: 10.3390/sym13122348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The significance of lower limb perfusion asymmetries remains unknown in healthy individuals. Our study aims to understand how factors such as posture, sex, age, and body weight relate to perfusion. Data from studies previously published by our group, including experiments using laser Doppler flowmetry as the gold standard for perfusion measurements in baseline, (various) challenge, and recovery phases was assembled from a total of 139 healthy participants. Body position was shown to be a primary determinant of perfusion asymmetry, especially in women. Effects of sex and age were also analyzed. In a supine position, perfusion asymmetries seemed to relate negatively in the aged group of participants, where challenge and recovery seemed to follow different processes. In the upright position, young men and women have shown comparable distributions and asymmetry ratios at baseline and recovery. In the aged group, differences between sexes were observed at baseline, but again, the course of the asymmetry ratios with challenge was essentially similar in men and women. Our analysis suggests that ageing is a critical determinant in our upright study sample, as higher baseline asymmetries and longer recoveries after challenge were linked in older males with higher body mass index (BMI).
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Florindo M, Nuno SL, Rodrigues LM. Lower limb dynamic activity significantly reduces foot skin perfusion- exploring data with different optical sensors in age-grouped healthy adults. Skin Pharmacol Physiol 2021; 35:13-22. [PMID: 34153970 DOI: 10.1159/000517906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 06/08/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Margarida Florindo
- Research Center for Biosciences and Health Technologies, Universidade Lusófona CBIOS, Lisboa, Portugal
- Department of Physiotherapy, ESSCVP the Portuguese Red Cross Health School, Lisboa, Portugal
| | - Sérgio Loureiro Nuno
- Research Center for Biosciences and Health Technologies, Universidade Lusófona CBIOS, Lisboa, Portugal
- Clínica S João de Deus - CTD, Lisboa, Portugal
- Escola Superior de Tecnologia da Saúde de Lisboa -ESTeSL Lisboas' Polytechnic Institute, Lisboa, Portugal
| | - Luis Monteiro Rodrigues
- Research Center for Biosciences and Health Technologies, Universidade Lusófona CBIOS, Lisboa, Portugal
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