Review of surgeon-performed point-of-care ultrasound imaging in plastic surgery

Ultrasound scanning (USS) is a well-established imaging modality with widespread clinical applications; however, it is still broadly underused by plastic surgeons. This review aims to understand the breadth of potential uses for surgeon-led point-of-care USS in plastic surgery.

A review of the literature was conducted by extracting articles from Medline, Embase, Google Scholar and Scopus databases relevant to USS use by plastic surgeons. Included articles were divided into themes corresponding to major fields of plastic surgery and their findings were extracted and summarised.

Major themes identified were “Upper limb”, “Microsurgery”, “Breast”, “Skin and soft tissues”, “Aesthetics” and “Regional anaesthesia”. USS was shown to have significant benefits in diagnostic, pre-operative planning and post-operative monitoring across the themes identified. Amongst others, its use as a bedside modality was particularly highlighted in evaluating structural hand injuries, pre-operative perforator mapping and post-operative monitoring in buried free flaps, clinic evaluation of breast implants for capsular contractures and ruptures, assessment of soft tissue infections such as necrotizing fasciitis and administration of regional blocks in the limbs and body such as transverse abdominal plane block as part of large abdominal surgeries.

Plastic surgeon–operated USS appears to have clear benefits in a wide range of uses within the field. With such a broad scope, it is clear that the modern plastic surgeons would benefit from proficiency in its use as a part of their repertoire and that its use should be taught to current trainees.

Level of Evidence: Not ratable