BACKGROUND: Pure skin perforator (PSP) flaps had shown their reliability and usefulness for the reconstruction of thin soft-tissue defects. However, accurate localization of PSP is required for safe and fast flap elevation. This study aimed to evaluate the usefulness of conventional high-frequency ultrasound (US) for PSP flap elevation. METHODS: Patients who underwent reconstruction using PSP flap based on the superficial branch of the superficial circumflex iliac artery (SCIA) were retrospectively included and divided into two groups according to the use of preoperative US mapping of SCIA PSPs
a portable US device with an 18 MHz probe was used to localize the PSP in a US group, whereas US was not used in a control group. Intraoperative findings and postoperative results were compared between the groups. RESULTS: Twenty-seven patients were included: 12 in the US group and 15 in the control group. There were no statistically significant differences in patient characteristics and postoperative results between the groups
both groups showed flap survival without major complications in all cases. Flap thickness ranged from 1.0 to 2.5 mm (average, 1.87 mm). Time for flap harvest was significantly shorter in the US group than in the control group (18.9 ± 4.5 vs. 50.5 ± 20.8 min, p <
0.001). CONCLUSIONS: Preoperative mapping of PSP using high-frequency US allowed reducing the surgical time for harvesting PSP flaps.