Imaging and Surgical Principles of the Gluteal Arteries and Perforator Flaps
The tremendous anatomic variability of the vascular system can make perforator ap reconstruction challenging for surgeons at all experience levels. Accurate preoperative anatomic imaging of vasculature greatly enhances the ability of devising a surgical strategy before going to the operating room. Preoperative knowledge of the best or dominant perforating vessels for each donor site shifts the brunt of the perforator selection process preoperatively, which can reduce operating time and general anaesthesia requirements and potentially increase ap success. In addition, the best donor site for a ap can be chosen based on patient preference, adequate tissue adiposity, and location of the best vessels.