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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to British Journal of Oral and Maxillofacial Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Definition of quality indications in microsurgery in head and neck reconstruction based on a 5-year follow-up without a loss.J Craniomaxillofac Surg. 2013; 41: 2-6
- Microvascular anastomotic coupler assessment in head and neck reconstruction.Otolaryngol Head Neck Surg. 2013; 149: 67-70
- Microvascular free flaps in head and neck surgery: complications and outcome of 1000 flaps.Int J Oral Maxillofac Surg. 2012; 41: 739-743
- Outcomes in head and neck reconstruction by surgical site and donor site.Laryngoscope. 2013; 123: 1612-1617
- Venous anastomoses using microvascular coupler in free flap head and neck reconstruction.J Oral Maxillofac Surg. 2012; 70: 992-996
- Analytic review of 2372 free flaptransfers for head and neck reconstruction following cancer resection.J Reconstr Microsurg. 2003; 19: 363-369
- 1000 consecutive venous anastomoses using the microvascular anastomotic coupler in breast reconstruction.Plast Reconstr Surg. 2010; 126: 1789
- Reliability of venous couplers for microanastomosis of the venae comitantes in free radial forearm flaps for head and neck reconstruction.J Reconstr Microsurg. 2013; 29: 433-436
- Microvascular free flaps in head andneck reconstruction: report of 200 cases and review of complications.Arch Otolaryngol Head Neck Surg. 1994; 120: 633-640
- Venous thrombosis in coupled versus sutured microvascular anastomoses.Ann Plast Surg. 2006; 57: 666-669
- Clinical experience in end to side venous anastomoses with a microvascular anastomotic coupling device in head and neck reconstruction.Arch Otolaryngol Head Neck Surg. 1999; 125: 869-872
- Arterial coupling for microvascular free tissue transfer in head and neck reconstruction.Arch Otolaryngol Head Neck Surg. 2005; 131: 891-895
- Arterial coupling for microvascular free tissue transfer.Otolaryngol Head Neck Surg. 2008; 138: 614-618
- Clinical experience with the 3M microvascular coupling anastomotic device in 100 free-tissue transfers.Plast Reconstr Surg. 1994; 93: 1481-1484
- Use of a mechanical microvascular anastomotic device in head and neck free tissue transfer.Arch Otolaryngol Head Neck Surg. 1996; 122: 529-532
- Routine use of microvascular coupling device for arterial anastomosis in breast reconstruction.Ann Plast Surg. 2006; 56: 365-368
Published online: December 19, 2019
Accepted: November 11, 2019
Received: May 10, 2019
© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.