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2 flaps in Group 2 underwent complete necrosis. Minor Hence, MDCTA was useful in planning the reconstruction of
complications including marginal flap necrosis (2 cases) complex defects requiring multiple paddles, similar to the
and infection (one case) were noted in Group 1 and were study done by Garvey et al. [13]
managed conservatively.
In conclusion, preoperative MDCTA as compared to Doppler
Prudent observations and surgical outcomes was more sensitive, specific, and accurate with respect to the
of this study location, course, and source vessel of all perforators. This study
2
• The largest skin paddle harvested measured 264 cm and demonstrates that preoperative MDCTA provides us with all the
survived. However, two flaps underwent complete necrosis information required to make a choice regarding design of the
(Group 2). In one, the MC perforator was injured, while in skin paddle and also reduces the flap harvest time which was
the other patient, the AMT perforator was dominant, but statistically significant. Our study showed that preoperative
eccentric to the skin paddle designed which was based MDCTA lowered the surgeons’ stress level during perforator
on a false localization by the Doppler signal. There was dissection. Further studies with large number of patients are
no perforator from the DBLCFA and the skin paddle had required to reach statistically significant conclusions. The trends
to be shifted proximally to include the TBLCFA perforator shown toward the benefits of performing preoperative MDCTA
(TBLCFAP), which in turn had a tortuous intramuscular course are nonetheless encouraging.
and was inadvertently injured. Preoperative MDCTA could
have picked up this anomaly, allowing the flap to be based on Financial support and sponsorship
the AMT perforator. A thoraco-umbilical flap was performed Nil.
as a salvage flap in this case. Two flaps had marginal necrosis
(Group 1), one of which occurred secondary to a problem
with the anastomosis. The recipient vessel posterior tibial Conflicts of interest
artery had three episodes of vasospasm despite revision of There are no conflicts of interest.
the anastomosis. This was attributed to the subacute phase
of injury. One patient in Group 2 with a defect of the upper REFERENCES
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58 Plast Aesthet Res || Vol 3 || Issue 2 || Feb 29, 2016