Imaging of perforasome territories: the evolution of techniques

**Background**: Perforator flaps are widely used in reconstructive plastic surgery and technological advances in preoperative imaging have facilitated improvements in flap perfusion and clinical outcomes. The ‘perforasome’ concept describes the vascular territory supplied by a single arterial perfor...

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Main Authors: Warren M Rozen, Rachael Leung, Michael P Chae, David J Hunter-Smith
Format: Article
Language:English
Published: Australian Society of Plastic Surgeons 2018-09-01
Series:Australasian Journal of Plastic Surgery
Online Access:https://doi.org/10.34239/ajops.v1i2.121
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author Warren M Rozen
Rachael Leung
Michael P Chae
David J Hunter-Smith
author_facet Warren M Rozen
Rachael Leung
Michael P Chae
David J Hunter-Smith
author_sort Warren M Rozen
collection DOAJ
description **Background**: Perforator flaps are widely used in reconstructive plastic surgery and technological advances in preoperative imaging have facilitated improvements in flap perfusion and clinical outcomes. The ‘perforasome’ concept describes the vascular territory supplied by a single arterial perforator and the imaging of these zones of perfusion has become increasingly advanced. **Methods**: This paper presents a qualitative analysis of the current literature on perforasome imaging. A review of the literature was performed using PubMed and Medline. Historical and background studies were also included for completeness. **Results**: The review identified an initial 858 records for assessment, with 52 studies formally reviewed. To date, there is largely level III and IV evidence for the available imaging techniques, although level II studies are emerging. There is currently no level I evidence for any imaging technique. **Conclusion**: There have been significant developments in imaging techniques since the introduction of the perforasome concept nearly a decade ago. In this review we have described the evolution of these methods over time, from simple perforator location to advanced three- and four-dimensional imaging and real-time dynamic perfusion imaging. With this progression and ongoing innovation, we believe perforasome imaging has the potential to improve outcomes in perforator flap surgery.
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spelling doaj-art-e37f9bd0e3ad4f3a99f55afc0bbd09da2025-08-20T02:40:11ZengAustralian Society of Plastic SurgeonsAustralasian Journal of Plastic Surgery2209-170X2018-09-011210.34239/ajops.v1i2.121Imaging of perforasome territories: the evolution of techniquesWarren M RozenRachael LeungMichael P ChaeDavid J Hunter-Smith**Background**: Perforator flaps are widely used in reconstructive plastic surgery and technological advances in preoperative imaging have facilitated improvements in flap perfusion and clinical outcomes. The ‘perforasome’ concept describes the vascular territory supplied by a single arterial perforator and the imaging of these zones of perfusion has become increasingly advanced. **Methods**: This paper presents a qualitative analysis of the current literature on perforasome imaging. A review of the literature was performed using PubMed and Medline. Historical and background studies were also included for completeness. **Results**: The review identified an initial 858 records for assessment, with 52 studies formally reviewed. To date, there is largely level III and IV evidence for the available imaging techniques, although level II studies are emerging. There is currently no level I evidence for any imaging technique. **Conclusion**: There have been significant developments in imaging techniques since the introduction of the perforasome concept nearly a decade ago. In this review we have described the evolution of these methods over time, from simple perforator location to advanced three- and four-dimensional imaging and real-time dynamic perfusion imaging. With this progression and ongoing innovation, we believe perforasome imaging has the potential to improve outcomes in perforator flap surgery.https://doi.org/10.34239/ajops.v1i2.121
spellingShingle Warren M Rozen
Rachael Leung
Michael P Chae
David J Hunter-Smith
Imaging of perforasome territories: the evolution of techniques
Australasian Journal of Plastic Surgery
title Imaging of perforasome territories: the evolution of techniques
title_full Imaging of perforasome territories: the evolution of techniques
title_fullStr Imaging of perforasome territories: the evolution of techniques
title_full_unstemmed Imaging of perforasome territories: the evolution of techniques
title_short Imaging of perforasome territories: the evolution of techniques
title_sort imaging of perforasome territories the evolution of techniques
url https://doi.org/10.34239/ajops.v1i2.121
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AT rachaelleung imagingofperforasometerritoriestheevolutionoftechniques
AT michaelpchae imagingofperforasometerritoriestheevolutionoftechniques
AT davidjhuntersmith imagingofperforasometerritoriestheevolutionoftechniques