Abstract
Our aim was to record our preliminary use of a microvascular coupler for arterial
anastomoses with free flap transfer in the reconstruction of oral and maxillofacial
defects in 45 patients with defects that were repaired with anterolateral thigh, fibular,
and radial forearm flaps. The microvascular coupler was used for both the venous and
the arterial anastomoses. The site of the defect, type of flap, recipient artery,
duration of operating time for the anastomosis, size of coupler, and survival of the
flap were recorded and analysed. A total of 45 consecutive patients had microsurgical
reconstructions in the head and neck, including 16 radial forearm, 18 fibular, and
11 anterolateral thigh free flaps. The sizes of coupler required ranged from 1.5-2.5 mm,
with most flaps (n = 30) requiring a 2.0 mm coupler. The mean (SD) operating time
for arterial anastomoses was 7 (2) mins. One arterial crisis occurred during an operation,
and required a sutured anastomosis instead. There were no complications related to
the technical performance of the coupler. The coupler is reliable for arterial anastomoses
of free tissue transfers in reconstructions of the head and neck. With proper selection
of vessels and enough experience in using the microvascular coupler, it may be used
in an expeditious, safe, and reliable fashion with minimal morbidity. Though not common,
the use of the coupler for arterial anastomoses saves a lot of time, and is a viable
alternative to a sutured anastomosis.
Keywords
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Article info
Publication history
Published online: December 19, 2019
Accepted:
November 11,
2019
Received:
May 10,
2019
Identification
Copyright
© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
