title: [Mechanical venous microanastomosis using a double ring eversion system in reconstructive surgery].
abstract: BACKGROUND
  The major complications of free flap surgery are anastomotic obstructions. The coupler, mechanical anastomosis using a double ring eversion system, yields higher venous patency rates than sutured anastomoses, and requires less operating time. We present our initial experience with this coupler in free flap surgery.
  
  
  METHODS
  We conducted this retrospective study between November 2011 and June 2012. We focused on complications having occurred in the first 10 patients having undergone free flap reconstruction (11 flaps) with end-to-end venous anastomosis using this coupler. Five flaps were used to fill cervico-facial defects in carcinologic surgery: one for mandibular osteoradionecrosis, one for cranioplasty coverage, one for cranial base reconstruction, two for skin defects in lower limb (heel, leg). One was an antebrachial radial flap, four anterolateral thigh flaps, five fibular flaps, and one latissimus dorsi flap. Fifteen veins were anastomosed. The diameters of the couplers used were 2.5 mm (3/15), 3 mm (6/15), and 3.5 mm (6/15).
  
  
  RESULTS
  There were no venous complications. One flap failed because of arterial ischemia.
  
  
  CONCLUSIONS
  The coupler is a fast and reliable alternative to usual sutures in free flap reconstructions, for head and neck as well as for limbs.
authors.affiliation: Service de chirurgie maxillo-faciale et plastique, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France; Laboratoire de physiologie de l'exercice, EA 4338, université Jean-Monnet, 42023 Saint-Étienne cedex 2, France.
authors.forename: V
authors.initials: V
authors.lastname: Prade
authors.forename: G
authors.initials: G
authors.lastname: Parrau
authors.forename: P
authors.initials: P
authors.lastname: Seguin
authors.forename: J
authors.initials: J
authors.lastname: Champin
authors.forename: T
authors.initials: T
authors.lastname: Alix
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D058752:Free Tissue Flaps / Q000009:adverse effects; D006083:Graft Occlusion, Vascular / Q000453:epidemiology; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects / Q000706:statistics & numerical data; D058017:Vascular Grafting / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods* / Q000706:statistics & numerical data; D014680:Veins / Q000601:surgery*; D055815:Young Adult
keywords: Anastomoses; Anastomosis; Microchirurgie; Microsurgery; Suture technique; Techniques de suture