A retrospective analysis of the surgical outcomes of different free vascularized flaps used for the reconstruction of the maxillofacial region: Hand-sewn microvascular anastomosis vs anastomotic coupler device

Abstract

The aim of the study was to assess the surgical outcomes following venous anastomosis with a coupling device and hand-sewn anastomosis in the reconstruction of the maxillofacial region. The study sample was recruited from patients who underwent reconstructive surgeries between January 2011 and November 2016. Tumor type, recipient veins, distribution of flap type, flap survival rates and anastomosis associated complications requiring a flap revision were documented. The follow-up period was four years. In total, 236 patients were included in this study, in which 201 reconstructions were performed via microsurgical venous coupling device (82.04%), whereas hand sewn anastomosis was used in 44 patients (17.96%). Postoperative complications regarding the anastomosis technique revealed that venous coupler devices showed significantly lower complications (4,97%) compared to hand sewn anastomosis (11,36%) (p < 0.05). Within the limitations of the current study, it can be concluded that the coupler system does appear to have advantages over conventional hand-sewn venous anastomosis and should be preferred when possible.