title: A comparison of microsurgical venous anastomosis techniques.
abstract: BACKGROUND
  Successful vascular anastomosis is essential for the survival of transferred free tissue. Arterial anastomosis is typically uncomplicated because the lumen is easily maintained and the vessel walls have elasticity. Venous anastomosis, however, is more time consuming because the vessel walls are thin and extensible. This article describes, reviews, and compares 3 currently used venous anastomosis techniques.
  
  
  METHODS
  From April 2012 through January 2014, free tissue transfer and supercharging pedicled tissue transfer were performed in 107 and 10 patients, respectively, at our hospital. According to the anastomotic technique used, patients (83 men and 34 women; mean age, 60.6 years) were divided into interrupted suture, continuous suture, and microvascular anastomotic coupling device (MACD) groups. Medical records were reviewed, and postoperative results were analyzed.
  
  
  RESULTS
  The diameter of anastomosed veins did not differ significantly among the groups. However, among the interrupted suture, continuous suture, and MACD groups, there were significant differences in vascular anastomosis time (51, 43.9, and 29.5 minutes, respectively) and transferred tissue ischemic time (151.9, 139.1, and 117.5 minutes, respectively). Surgical site infection occurred in 9 patients, and flap necrosis occurred in 2 patients. However, complication rates did not differ significantly among the 3 groups.
  
  
  CONCLUSIONS
  The venous anastomosis technique does not affect the complication rate but does affect anastomosis time and flap ischemia time. On the basis of these results, we believe that the continuous suture and MACD techniques are easier and safer for venous anastomosis than is the traditional interrupted suture technique.
authors: Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School.
authors: Hiroki
authors: H
authors: Umezawa
authors: Rei
authors: R
authors: Ogawa
authors: Munenaga
authors: M
authors: Nakamizo
authors: Kazuhiko
authors: K
authors: Yokoshima
authors: Hiko
authors: H
authors: Hyakusoku
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D007564:Japan; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology; D013536:Suture Techniques / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D014680:Veins / Q000601:surgery*