Surgical oncology and reconstructionVenous Anastomoses Using Microvascular Coupler in Free Flap Head and Neck Reconstruction
Section snippets
Materials and Methods
We retrospectively reviewed 184 consecutive cases of microvascular free flaps performed at the University of Maryland Medical Center, Department of Oral and Maxillofacial Surgery between May 2007 and September 2010. This study was granted exemption by the institutional review board. Surgeries were performed by 4 attending surgeons (J.L., A.S., J.C., D.C.) with fellows and residents. Patient data were collected from hospital records and operative reports. The following specific data points were
Results
In total, 178 microvascular free flaps were performed on 164 patients, including 56 females and 108 males. The mean age of patients was 56 years (range 13 to 88). Eight patients underwent 2 separate free flap procedures, and 1 patient underwent 3 free flaps. Simultaneous free flaps (double flaps) were performed on 4 patients. Thirty-four patients received preoperative external beam radiotherapy. Surgical defects were due to malignant pathology (66.3%, 118/178), benign pathology (29.2%, 52/178),
Discussion
The microvascular anastomosis coupler device is currently manufactured by Synovis Micro Companies Alliance. The device consists of 2 disposable rings made of high-density polyethylene, with a series of 6 to 8 (depending on the size of the coupler) stainless steel pins evenly spaced around each ring. The inner diameter of the rings range in size from 1.0 to 4.0 mm, allowing anastomoses of vessels that are 1.0 to 4.5 mm in diameter.
A series of 178 free flaps were reviewed in this study. The
Acknowledgment
We are grateful to Dr Cyrus Mistry and Dr Biraj Shah for their work on data collection.
References (10)
- et al.
Free-flap failures and complications in an American Oral and Maxillofacial Surgery Unit
Int J Oral Maxillofac Surg
(2009) - et al.
Clinical experience of a microvascular venous coupler device in free tissue transfers
Kaohsiung J Med Sci
(2007) - et al.
Single versus dual venous drainage of the radial forearm free flap
Am J Otolaryngol
(1996) - et al.
Double venous anastomosis for the radial artery forearm flapImproving success and minimising morbidity
J Craniomaxillofac Surg
(2009) - et al.
Arterial coupling for microvascular free tissue transfer
Otolaryngol Head Neck Surg
(2008)
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2018, International Journal of Oral and Maxillofacial SurgeryCitation Excerpt :A flow diagram of the study selection process is presented in Fig. 1. All 27 articles reported retrospective studies13–19,34–53. The included studies involved a total of 7389 flaps for head and neck reconstruction.