title: Clinical experience with 80 microvascular couplers in 64 free osteomyocutaneous flap transfers for mandibular reconstruction.
abstract: Microvascular couplers have been introduced as an alternative method for anastomosis in mandibular reconstruction. This study included 64 patients who had undergone free flap reconstruction for mandibular defects and had been scheduled for follow-up at 1, 3, 6, and 12 months. After completion of the tumour resection and harvesting of the osteomyocutaneous flap, appropriate preparation of both ends of the vessels was performed for microsurgery. Single-vein anastomoses were performed in 35 patients and double-vein anastomoses in 29 patients. Except for 75 couplers used for venous anastomosis only, both arterial and venous anastomoses were performed using the coupler in seven flaps. No flap failures occurred in these cases, resulting in an overall flap success rate of 100%. As expected, anastomoses were completed successfully using the coupler in 78 out of 80 attempted cases (97.5%). Additional large and randomized studies are needed to compare the outcomes of coupler anastomoses to those of traditional sutured anastomoses, and to define to what extent this would present cost-savings per procedure.
authors.affiliation: The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine Ministry of Education, Wuhan University, Wuhan, China.
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Oral and Maxillofacial - Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: K
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Oral and Maxillofacial - Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Shao
authors.affiliation: The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine Ministry of Education, Wuhan University, Wuhan, China; Department of Oral and Maxillofacial - Head and Neck Oncology, School and Hospital of Stomatology, Wuhan University, Wuhan, China. Electronic address: shangzhengjun@hotmail.com.
authors.forename: Z-J
authors.initials: ZJ
authors.lastname: Shang
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000295:instrumentation*; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D061646:Operative Time; D010348:Patient Care Team; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: artery; coupler microanastomosis; mandibular reconstruction