Reduced venous thrombosis and re‐exploration time with anastomotic coupling device: A cohort study. Issue 5 (30th December 2015) - Coroneos, Christopher J.
Abstract : Objective: In the anastomotic coupling device literature, no comparative study has reported operative times, included consecutive patients, or used a matched comparison group. Our objective was to analyze patency and operative time in free flaps with venous anastomoses performed with ACD versus hand‐sewn. Methods : For consecutive free flaps, re‐explorations and complications were reviewed in duplicate. Operative times for ACD versus hand‐sewn were compared for: (1) matched unilateral DIEPs, and (2) re‐explorations. Results : Overall, 147 ACD and 144 hand‐sewn flaps were included. Venous thrombosis was significantly lower with ACD (1/147[1%] vs.9/144[6%], P < 0.01). There was no difference in re‐exploration for venous insufficiency, or overall re‐exploration. Re‐exploration time was significantly shorter with ACD (69mins vs.205mins, P = 0.009). Conclusions : ACD significantly decreases venous thrombosis compared to hand‐sewn veins, and significantly shortens re‐exploration time. Outcomes allow an estimate of cost utility for the ACD in decreasing venous thromboses and shortening re‐exploration time. © 2015 Wiley Periodicals, Inc. Microsurgery 36:372–377, 2016.