الفهرس 
Vascular Anatomy of the Lower legOnly 14 pages are availabe for public view
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Abstract
A
s a result of individual anatomic variations, surgeons are not able to confidently predict that a perforator actually exists at a particular site. So, it is crucial to locate faciocutaneous perforators preoperatively. A reliable method for the precise identification of the perforators would be extremely valuable.
A variety of methods have previously been used to evaluate the perforator locations within the lower limb. Preoperative identification of fasciocutaneous perforators is possible with Color Duplex Sonography. Color Duplex Sonography can estimate the relative size of the perforators even in obese patients. In addition, surrounding anatomical information provided by this method is very helpful in elevating any fasciocutaneous flap. By mapping a particular perforator with preoperative Color Duplex sonography, individual flaps may be designed to lie exactly over the perforator, ensuring blood supply to the flap.
By means of colour duplex sonography the surgeon can spot the respective main vessel of a perforator and then follow the course of the branches diverging from this vessel up to the skin. Already during this preoperative examination, the exact site of the individual perforating vessel can be marked and thus the surgeon will have the necessary information for harvesting the flap. This information guarantees the best preparation to perform successful flap coverage.
However, Color Duplex Sonography has limitations. It is reliability depends on a skilful knowledgeable person of device, radiology and flap surgery. Additionally, our observations proved that distances vary individually. This means that each human individual has its own pattern. Consequently, the prediction of the exact distances is impossible.
Although specificity is high, Color Duplex Sonography has low sensitivity this may be due to the small size of these perforators that cannot be detected by duplex. Also, the lack of resources and expertise can restrict color duplex availability as well as its use because its results are dependent on the operator, who is expected to have some knowledge and familiarity with the perforators.