Technique And Clinical Experience Of The Unilink/3M® Microvascular Anastomotic Coupling Device In Free Flap Surgery.

Abstract

We report our experience using the Unilink/3M® microvascular anastomotic coupling device in free flap surgery. Ninety-nine anastomoses were performed in 99 free flaps using the Unilink/3M® coupling device between June 1995 and August 2000. The device was used for the venous anastomosis in 95 flaps, and for both the arterial and venous anastomoses in 4 flaps. All anastomoses were performed in an end-to-end fashion. Ninety-one flaps were performed for breast reconstruction and 8 for head and neck reconstruction. There were 54 TRAM flaps, 18 bilateral TRAM, 4 VRAM, 2 fibula, 1 DCIA, 1 latissimus dorsi, and 1 scapular flap. Flap survival was 100%. Anastomoses using the Unilink/3M® coupling device were completed successfully in 99 out of 104 attempted cases (95%). Two venous anastomoses were revised intraoperatively (1 for twisting) using the coupler for the second anastomosis, and 5 attempted anastomoses required intraoperative conversion to sutured anastomoses. There was 1 late venous thrombosis (23 days postoperatively), but this did not result in any flap loss. The average time for anastomosis was less than 5 minutes. The Unilink/3M® coupling device is a safe, reliable method for performing microvascular venous anastomoses, allowing reduced operating time in free flap surgery.