Detection of perforators is usually a crucial requirement for a reconstructive plastic surgeons. Despite the availability of many advanced and far reliable options for preoperative perforator detection, many relay solely on Doppler because of its low cost and ease of use. We share our experience of perforator detection ,using Doppler and assess its accuracy by intra-operative localization . Methods: In one year prospective study, included all patients planned for AL TF. We did preoperative perforator mapping using Doppler and check their intra-operative location for accuracy of detection. We also looked for quality of detected perforator and number of non detected perforators. Results: Total of 276 perforators of 82 ALTF were marked. Only 194 (70.2 %) locations have perforator and 121(43.8 %) of them were of good size. Doppler marking was false positive in rest of the locations. There were also a total of 134 good sized perforators located intra operatively which were not preoperatively detected by Doppler. Conclusion: We suggested that Doppler is not sufficient for reliable detection and planning of ALTF.
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