Comparison of hand-sewn versus modified coupled arterial anastomoses in head and neck reconstruction: a single operator’s experience |
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| Institution: | 1. State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China;2. State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China;1. Department of Oral/Maxillofacial Surgery and Oral Pathology, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria;2. Department of Medicine, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria;1. Department of General Surgery, Medical University of Vienna, Vienna, Austria;2. Department of Neurosurgery, Medical University Vienna, Vienna, Austria;3. Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria;4. Department of Cranio-Maxillofacial and Oral Surgery, Sanatorium Hera, Vienna, Austria;1. Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD, USA;2. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA;3. TMJ Concepts, Ventura, CA, USA;4. Department of Oral and Maxillofacial Surgery, The University of Oklahoma, Oklahoma City, OK, USA |
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| 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. |
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| Keywords: | couplers flaps head and neck reconstruction microanastomosis artery |
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