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Three-dimensional digitalized virtual planning for saphenous artery flap: a pilot study.
Comput Assist Surg (Abingdon). 2016 12; 21(1):102-106.CA

Abstract

OBJECTIVE

Since the 1970s, research and applications on flap and muscle flap had solved many problems in microsurgical reconstruction. However, the traditional flap design is completely dependent on two-dimensional (2D) images. The purpose of this study was to discuss the methods in the visualization of saphenous artery flap by digitalized technique and its applications by digitalized technique.

METHODS

Two adult fresh cadaver specimens, one male and one female, were subject to radiographic computerized tomography (CT) scanning before and after perfused with lead oxide-gelatine mixture, whose collimation are 0.625 mm (120 kV, 110 mA, 512 × 512 matrix). Through Amira 5.4.1 software, the 2D images in DICOM format were transformed into the 3D models of the entire region. The structures of saphenous artery were observed and the digitized visible models of saphenous artery flap were established through three-dimensional (3D) computerized reconstructions methods from these data using Amira 5.4.1 software. Next six cases of soft-tissue defects of the tibia region, involving the exposure bones underwent contrast-enhanced CT angiography of lower limbs utilizing a 64-row multi-slice spiral CT after median cubital vein injection with Ultravist (3.5 ml/s). 2D images from these data in DICOM format were transformed into computer. The structures of saphenous artery flap were observed and measured using Amira 5.4.1 software. Then, all cases were treated by saphenous artery flap.

RESULTS

The 3D reconstructed visible models established from these datasets perfectly displayed the saphenous artery flap anatomy. In six cases, the main trunk and branched of the blood vessels in the designed flap were consistent with the surgical findings. The starting point of the saphenous artery to the average distance of the knee clearance were 119.2 ± 9.6 mm, the average diameter of the saphenous artery from the starting point were 1.5 ± 0.3 mm. The range of flap was 8.0 × 5.0 cm to 20.0 × 8.0 cm. All flaps survived well. After 8-24 months' follow-up the knee flexion was 120-140°, the straight 0-10°. There was no case appeared incision infection.

CONCLUSIONS

The preoperative use of 3D digitalized virtual planning for the saphenous artery flap improves the surgical accuracy, decreases the operation time and increases the survival rate of the flap.

Authors+Show Affiliations

Zhang YZ
a Department of Orthopaedics , the Affiliated Hospital of Inner Mongolia Medical University , Hohhot , People's Republic of China.
Wen SZ
b Department of Orthopaedics , the Second Affiliated Hospital of Inner Mongolia Medical University , Hohhot , People's Republic of China.
Zhang HQ
c Department of Special Diagnosis , Inner Mongolia Unit hospital of Chinese Armed Police Force , Hohhot , People's Republic of China.
Li YG
b Department of Orthopaedics , the Second Affiliated Hospital of Inner Mongolia Medical University , Hohhot , People's Republic of China.
Zhao JM
c Department of Special Diagnosis , Inner Mongolia Unit hospital of Chinese Armed Police Force , Hohhot , People's Republic of China.
Yang Y
a Department of Orthopaedics , the Affiliated Hospital of Inner Mongolia Medical University , Hohhot , People's Republic of China.

MeSH

AngiographyCadaverContrast MediaFemaleHumansImaging, Three-DimensionalLegMalePilot ProjectsSoftwareSurgery, Computer-AssistedSurgical FlapsTomography, X-Ray Computed

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27973959

Citation

Zhang, Yuan Z., et al. "Three-dimensional Digitalized Virtual Planning for Saphenous Artery Flap: a Pilot Study." Computer Assisted Surgery (Abingdon, England), vol. 21, no. 1, 2016, pp. 102-106.
Zhang YZ, Wen SZ, Zhang HQ, et al. Three-dimensional digitalized virtual planning for saphenous artery flap: a pilot study. Comput Assist Surg (Abingdon). 2016;21(1):102-106.
Zhang, Y. Z., Wen, S. Z., Zhang, H. Q., Li, Y. G., Zhao, J. M., & Yang, Y. (2016). Three-dimensional digitalized virtual planning for saphenous artery flap: a pilot study. Computer Assisted Surgery (Abingdon, England), 21(1), 102-106.
Zhang YZ, et al. Three-dimensional Digitalized Virtual Planning for Saphenous Artery Flap: a Pilot Study. Comput Assist Surg (Abingdon). 2016;21(1):102-106. PubMed PMID: 27973959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Three-dimensional digitalized virtual planning for saphenous artery flap: a pilot study. AU - Zhang,Yuan Z, AU - Wen,Shu Z, AU - Zhang,Hui Q, AU - Li,Ya G, AU - Zhao,Jian M, AU - Yang,Yong, PY - 2016/12/16/entrez PY - 2016/12/16/pubmed PY - 2018/3/27/medline KW - Imaging KW - flap KW - saphenous artery KW - three-dimensional SP - 102 EP - 106 JF - Computer assisted surgery (Abingdon, England) JO - Comput Assist Surg (Abingdon) VL - 21 IS - 1 N2 - OBJECTIVE: Since the 1970s, research and applications on flap and muscle flap had solved many problems in microsurgical reconstruction. However, the traditional flap design is completely dependent on two-dimensional (2D) images. The purpose of this study was to discuss the methods in the visualization of saphenous artery flap by digitalized technique and its applications by digitalized technique. METHODS: Two adult fresh cadaver specimens, one male and one female, were subject to radiographic computerized tomography (CT) scanning before and after perfused with lead oxide-gelatine mixture, whose collimation are 0.625 mm (120 kV, 110 mA, 512 × 512 matrix). Through Amira 5.4.1 software, the 2D images in DICOM format were transformed into the 3D models of the entire region. The structures of saphenous artery were observed and the digitized visible models of saphenous artery flap were established through three-dimensional (3D) computerized reconstructions methods from these data using Amira 5.4.1 software. Next six cases of soft-tissue defects of the tibia region, involving the exposure bones underwent contrast-enhanced CT angiography of lower limbs utilizing a 64-row multi-slice spiral CT after median cubital vein injection with Ultravist (3.5 ml/s). 2D images from these data in DICOM format were transformed into computer. The structures of saphenous artery flap were observed and measured using Amira 5.4.1 software. Then, all cases were treated by saphenous artery flap. RESULTS: The 3D reconstructed visible models established from these datasets perfectly displayed the saphenous artery flap anatomy. In six cases, the main trunk and branched of the blood vessels in the designed flap were consistent with the surgical findings. The starting point of the saphenous artery to the average distance of the knee clearance were 119.2 ± 9.6 mm, the average diameter of the saphenous artery from the starting point were 1.5 ± 0.3 mm. The range of flap was 8.0 × 5.0 cm to 20.0 × 8.0 cm. All flaps survived well. After 8-24 months' follow-up the knee flexion was 120-140°, the straight 0-10°. There was no case appeared incision infection. CONCLUSIONS: The preoperative use of 3D digitalized virtual planning for the saphenous artery flap improves the surgical accuracy, decreases the operation time and increases the survival rate of the flap. SN - 2469-9322 UR - https://www.unboundmedicine.com/medline/citation/27973959/Three_dimensional_digitalized_virtual_planning_for_saphenous_artery_flap:_a_pilot_study_ DB - PRIME DP - Unbound Medicine ER -