Abstract
Flow couplers for venous anastomosis, which enable the invasive monitoring of free
flaps during the postoperative period with a continuous venous signal audible immediately
after completion of the anastomosis, have been reported to be reliable, sensitive,
and specific as anastomotic flap monitoring adjuncts. The purpose of this study was
to evaluate the reliability, sensitivity, specificity, and outcomes of surgical exploration,
and the impact on free-flap survival of the venous anastomotic flow coupler for microvascular
head and neck reconstruction in a consecutive series of patients. This is a retrospective
review of consecutive patients treated in the department of oral and maxillofacial
surgery who underwent reconstruction of a head and neck defect using venous anastomosis
with a flow coupler-vascularised free flap between October 2015 and December 2020.
A total of 189 patients had free-flap reconstruction of head and neck defects. We
compared the venous flow coupler group (n = 72) with patients who had free flaps with
hand-sewn anastomoses over the same period (n = 117). There were no false positive/negatives
associated with the flow coupler as an implantable flap monitor. The flow coupler
cohort had a significantly higher flap salvage rate compared with free flaps that
were monitored clinically (p = 0.04). The venous flow coupler has been shown to be
a reliable microvascular anastomotic and invasive flap monitor that enables accurate
and timely detection of flap compromise and prompt, successful free-flap salvage.
Keywords
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Article Info
Publication History
Published online: January 12, 2022
Accepted:
January 6,
2022
Received in revised form:
January 2,
2022
Received:
October 25,
2021
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
