title: Outcomes after 1.9-microm diode laser-assisted anastomosis in reconstructive microsurgery: results in 27 patients.
abstract: BACKGROUND
  Microvascular surgery has become an important method for reconstructing surgical defects resulting from trauma, tumors, or burns. The most important factor for successful free flap transfer is a well-executed anastomosis. This study was performed to review the authors' experience with a 1.9-microm diode laser in microsurgery, with special attention to outcomes and performance of the technique.
  
  
  METHODS
  Between January of 2005 and December of 2007, 27 patients underwent microsurgery with a 1.9-microm diode laser at the authors' institute. The patients had a mean age of 31 years (range, 2 to 59 years); 14 patients were women and 13 patients were men. This technique was used for digital replantations (n = 2) and for free flap transfer (n = 27). Causes of the defects were trauma (n = 14), tumor (n = 9), congenital (n = 2), burn (n = 1), infection (n = 1), arthritis (n = 1), and dog bite (n = 1). Laser-assisted microvascular anastomosis was performed with a 1.9-microm diode laser after placement of equidistant stitches. The following parameters were used: spot size, 400 microm; power, 125 mW; time depending on vessel size (0.8 to 1.8 mm); and fluence varying from 70 to 200 J/cm.
  
  
  RESULTS
  Three surgical revisions following hematoma and one rupture of the arterial anastomosis leading to a free deep inferior epigastric perforator flap necrosis resulting from high-dose radiotherapy before surgery occurred after laser-assisted microvascular anastomosis, accounting for an overall success rate of 96.6 percent.
  
  
  CONCLUSIONS
  This study reports the numerous benefits of the technique: easier performance of vascular anastomosis with difficult access, decrease of reperfusion bleeding and complications, and a short learning curve.
authors.affiliation: Loos, Lesquin, and Lille From the Department of Plastic Surgery, Handcenter of Lille Sud Clinic and Lille University Hospital; and INSERM, French National Institute of Health and Medical Research, Université Lille Nord de France, Lille University Hospital.
authors.forename: Franck M P
authors.initials: FMP
authors.lastname: Leclère
authors.forename: Michel
authors.initials: M
authors.lastname: Schoofs
authors.forename: Bruno
authors.initials: B
authors.lastname: Buys
authors.forename: Serge R
authors.initials: SR
authors.lastname: Mordon
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods*; D001168:Arthritis / Q000601:surgery; D002056:Burns / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000098:blood supply / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D054023:Lasers, Semiconductor; D008297:Male; D008866:Microsurgery / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult