超声彻底改变了重建显微外科手术,提供实时成像和增强的精度,允许术前皮瓣规划,受体血管识别和选择,术后皮瓣监测,还有淋巴手术.这篇文献的叙述性综述提供了基于证据的更新,概述了超声在显微外科中的当前应用和新兴前沿。专注于自由组织转移和淋巴手术。彩色双工超声(CDU)在术前皮瓣规划和设计中起着举足轻重的作用,提供实时成像,实现详细的穿孔器映射,射孔器适用性评估,血流速度测量,and,最终,襟翼设计优化。超声还通过提供口径评估来帮助受体血管选择,通畅,location,和受体血管的流速。术后,超声可以实时监测皮瓣灌注,提供早期发现潜在的皮瓣妥协和提高皮瓣存活率。在淋巴手术中,超高频超声(UHFUS)提供精确的测绘和评估淋巴管,通过靶向更大的扩张血管来提高疗效和效率。将超声集成到重建显微外科手术中代表了该领域成像利用的显着进步。随着设备可访问性的增加,改进培训,和技术进步,使用超声作为关键的成像工具为重建显微外科手术的发展提供了巨大的潜力。
Ultrasound has revolutionized reconstructive microsurgery, offering real-time imaging and enhanced precision allowing for preoperative flap planning, recipient vessel identification and selection, postoperative flap monitoring, and lymphatic surgery. This narrative review of the literature provides an updated evidence-based overlook on the current applications and emerging frontiers of ultrasound in microsurgery, focusing on free tissue transfer and lymphatic surgery. Color duplex
ultrasound (CDU) plays a pivotal role in preoperative flap planning and design, providing real-time imaging that enables detailed perforator mapping, perforator suitability assessment, blood flow velocity measurement, and, ultimately, flap design optimization.
Ultrasound also aids in recipient vessel selection by providing assessment of caliber, patency, location, and flow velocity of recipient vessels. Postoperatively,
ultrasound enables real-time monitoring of flap perfusion, providing early detection of potential flap compromise and improved flap survival rates. In lymphatic surgery, ultra-high frequency
ultrasound (UHFUS) offers precise mapping and evaluation of lymphatic vessels, improving efficacy and efficiency by targeting larger dilated vessels. Integrating ultrasound into reconstructive microsurgery represents a significant advancement in the utilization of imaging in the field. With growing accessibility of devices, improved training, and technological advancements, using ultrasound as a key imaging tool offers substantial potential for the evolution of reconstructive microsurgery.