Terminology

HHUS: Perioperative hand-held ultrasound identification of perforators.

Color Duplex-US: locates perforator arteries and determines flow direction and diameter (2D image) preoperatively using high-frequency color duplex ultrasound.

CTA: preoperative CT scan using iodine-containing contrast medium with early arterial phase scan to identify perforators, potentially supplemented by late phase scan to identify veins. 3D reconstructions are possible using post-processing.

MRA: MRI scan made with intravenous gadolinium, allowing identification of arterial and venous perforators. 3D reconstructions are possible using post-processing.

TRAM flap: skin-fat-muscle flap harvested from the rectus abdominis muscle, which can be used pedicled or free.

DIEP-flap: free skin and fat flap, perfused by perforating arteries from the deep inferior epigastric artery.

Operative time: time of the procedure in the operating room.

Mapping: standardized approach to assess vascular anatomy; starting at the umbilicus, the abdominal wall is divided into 4 x 4 cm zones within which the perforators are plotted, particularly medial and lateral branches.