Perforator Flap Breast Reconstruction Workup

Updated: May 09, 2023
  • Author: Frank J DellaCroce, MD; Chief Editor: James Neal Long, MD, FACS  more...
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Laboratory Studies

Basic presurgical laboratory studies include blood counts and chemistries. ECGs and chest x-rays are obtained according to pre-anesthesia guidelines.


Imaging Studies

Color-flow Doppler and CT angiography have been used for imaging of blood flow patterns in various perforator flaps. They may be of use when the integrity or pattern of blood flow within the flap is in question. [12, 13] However, these modalities are not typically employed in routine clinical practice.

A study by Davis et al indicated that CT angiography carried out prior to microsurgical breast reconstruction can be used to identify whether a DIEP flap will be at greater risk for postoperative venous congestion. The investigators reported that flaps found on CT angiography to have atypical venous connections between the deep and superficial systems, ie, those in which the connections were narrow, tortuous, or incomplete, had a five-fold risk of such congestion. [14]