Clinical application of microvascular free flaps has expanded widely in the past decades by evolved research of microanatomy and physiology of cutaneous tissue. Now, free flap donor sites, which is needed for resurfacing of defects, have become numerous. Choice of a suitable donor site is determined carefully depending on the following factors ; In recipient site-site & volume(size, thickness), condition of recipient. bed, vessel condition etc., In donor site-age, sex, past history, obesity, thickness & texture of flap, difficulty of flap elevation, length & diameter of vessel, morbidity of donor site etc., One of the most important factors is the thickness of subcutaneous tissue layer.
Methods for preoperative evaluation of subcutaneous thickness are skin fold, soft tissue reontgenogram, needle puncture, skin incision, electroconductivity test and ultrasonic measurement. The ultrasonic measurement of subcutaneous tissue thickness may be more accurate than other methods.
Subcutaneous tissue thickness was measured ultrasonically on 51 individuals of ages between 6 and 59 years. Measurements were obtained at nine sites ; pectoralis major, rectus abdominis, groin, upper arm, forearm, scapula, latissimus dorsi, lateral thigh and dosalis pedis. The thickest skin and subcutaneous tissue was noted at the rectus abdominis(1O.2mm) and the thinnest at the dosalis pedis(3.8mm). The subcutaneous tissue thickness of children was more thicker than adults at the lateral thigh, upper arm and forearm. Ultrasonic measurement of subcutaneous tissue thickness is an excellentt parameter of preoperative evaluation and postoperative evaluation in free flap bulkiness.
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