title: Reduced venous thrombosis and re-exploration time with anastomotic coupling device: A cohort study.
abstract: OBJECTIVE
  In the anastomotic coupling device literature, no comparative study has reported operative times, included consecutive patients, or used a matched comparison group. Our objective was to analyze patency and operative time in free flaps with venous anastomoses performed with ACD versus hand-sewn.
  
  
  METHODS
  For consecutive free flaps, re-explorations and complications were reviewed in duplicate. Operative times for ACD versus hand-sewn were compared for: (1) matched unilateral DIEPs, and (2) re-explorations.
  
  
  RESULTS
  Overall, 147 ACD and 144 hand-sewn flaps were included. Venous thrombosis was significantly lower with ACD (1/147[1%] vs.9/144[6%], P < 0.01). There was no difference in re-exploration for venous insufficiency, or overall re-exploration. Re-exploration time was significantly shorter with ACD (69mins vs.205mins, P = 0.009).
  
  
  CONCLUSIONS
  ACD significantly decreases venous thrombosis compared to hand-sewn veins, and significantly shortens re-exploration time. Outcomes allow an estimate of cost utility for the ACD in decreasing venous thromboses and shortening re-exploration time. © 2015 Wiley Periodicals, Inc. Microsurgery 36:372-377, 2016.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Coroneos
authors.affiliation: Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: Sophocles H
authors.initials: SH
authors.lastname: Voineskos
authors.affiliation: Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: Adrian M
authors.initials: AM
authors.lastname: Heller
authors.affiliation: Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: Ronen
authors.initials: R
authors.lastname: Avram