Perforator flaps from the thigh region carry many advantages in the reconstructive paradigm, yet they still have some disadvantages, mainly variation in the vascular anatomy. The current study was conducted on nine patients planned for anterolateral thigh flap elevation and were examined   preoperatively   by   doppler,   color   duplex   and   angiographic   studies.
Results: It was found that there was a statistically significant difference between the number of perforators detected by doppler and those detected by color duplex on either side; all perforators that were detected by preoperative color duplex examination were found intra- operatively although in one patient the perforator was detected further away from the planned site. The duplex alone could be a reliable tool in detecting & locating perforators accurately giving the surgeon enough data about the perforator's anatomy necessary for performing the procedure and elevating the flap safely and promptly.
Conclusion: Color Duplex alone is a reliable method for detection of the perforators of the anterolateral thigh flap.