Comparison of hand-sewn versus modified coupled arterial anastomoses in head and neck reconstruction: a single operator's experience. Issue 9 (September 2020)

• Record Type: Journal Article
• Authors: Guo, Z.; Cui, W.; Hu, M.; Yu, B.; Han, B.; Li, Y.; Tang, X.; Li, C.; Li, L.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 49:Issue 9(2020:Sep.)
• Page Start: 1162
• Page End: 1168
• Publication Date: 2020-09
• Subjects: couplers -- flaps -- head and neck -- reconstruction -- microanastomosis -- artery; Mouth -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Dentistry -- Periodicals; Dentistry, Operative; Oral Surgical Procedures; Surgery, Oral; Dentistry; Maxilla -- Surgery; Mouth -- Surgery; Electronic journals; Periodicals; 617.52059
• DOI: 10.1016/j.ijom.2020.01.019
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: Microvascular coupler devices have gained wide acceptance as an alternative to the traditional hand-sewn technique in reconstructive surgery. However, no study has directly compared the efficacy of the coupler and hand-sewn techniques in arterial anastomosis during head and neck reconstruction surgery. A total of 123 patients who underwent surgery performed by a single surgeon between 2016 and 2018 were included in this retrospective study. The patients were divided into the coupler group and the hand-sewn group according to the technique of arterial anastomosis used. Patients in the coupler group underwent a special procedure including arterial bifurcation to enlarge the recipient artery diameter. Of the 123 free flap surgeries performed, 56 were done using a coupler and 67 with the standard suture technique. One flap in the coupler group failed due to simultaneous arterial and venous thromboses. One flap in the hand-sewn group was lost due to venous compromise. The overall flap survival rate was 98.4% ( n = 121). There was a significant decrease in anastomotic time when a coupler was used ( P < 0.001). The complication and flap loss rates were similar in the coupler and hand-sewn groups. The application of the coupler helped to decrease the anastomotic time and achieved satisfactory vessel patency.