A Review of Objective Measurement of Flap Volume in Reconstructive Surgery

BACKGROUND: The utility and efficacy of 3-dimensional representation have been proven in bony reconstruction; however, its role in soft-tissue reconstruction remains limited. There is currently no reliable gold standard to objectively measure flap volume. This systematic review aims to summarize the available techniques used to objectively measure flap volume in reconstructive surgery. METHODS: A systematic literature search was performed to identify all relevant articles describing objective techniques to quantify flap volume. The search included published articles in 3 electronic databases—Ovid MEDLINE, EMBASE, and PubMed. RESULTS: A total of 16 studies were included. Flap volume was calculated using the following techniques: magnetic resonance imaging, computed tomography, 3-dimensional imaging and modeling, material templates, ultrasound, and weighing scales. Techniques and results of the included studies are summarized. CONCLUSIONS: This systematic review provides a summary of various published techniques for objective pre- or intraoperative quantification of flap volume in reconstructive surgery. The preliminary results from this review are promising, and we believe that 3-dimensional representation and objective quantification is the future of reconstructive flap surgery. More studies are needed to study the clinical relevancy and impact of the various imaging modalities reviewed and to develop automated volumetric measurement technology with improved accuracy, efficacy, and reproducibility.