title: A Comparative Study on Microvascular Anastomosis of Vascularised Free Fibular Flap with Couplers and Suturing in Mandibular Reconstruction.
abstract: BACKGROUND
  Successful outcome of any vascularised free flap basically depends upon the successful restoration of circulation in the flap after anastomosis. As the flap ischemic time is the significant factor which determines the outcome of any free flaps, due consideration is given to reduce the time for anastomosis for reperfusion. The present study compares and evaluates whether the usage of microvascular couplers with the conventional suturing reduce the ischemic time of the free flaps.
  
  
  METHODS
  Thirty patients were randomly divided into two groups (each group consisting of 15 patients) for mandibular reconstruction using free fibular microvascular flap. In group 1, microanastomosis was done with conventional suturing whereas microvascular couplers were used in group 2. Intraoperatively, patency, leakage and tissue perfusion were assessed. The time taken for anastomosis (time taken for suturing and applying couplers) and flap ischemic time (from the time of flap division from the donor site till the flap is reperfused after anastomosis) were calculated for both the groups.
  
  
  RESULTS
  Significant decrease in time for anastomosis was observed in group 2, which resulted in decrease in flap ischemic time and in overall operating time.
authors.affiliation: Department of Oral and Maxillofacial Surgery, SRM Dental College, Ramapuram, Chennai, 600089 India ; DWIJAN Research Institute, F5, Whitefields,Victoryfield Extn, Alex Nagar, Madhavaram, Chennai, 600051 India.
authors.forename: Senthil
authors.initials: S
authors.lastname: Murugan
authors.affiliation: Department of OMFS, VMS Dental College, Salem, India.
authors.forename: Reena Rachel
authors.initials: RR
authors.lastname: John
authors.affiliation: Department of Oral and Maxillofacial Surgery, SRM Dental College, Ramapuram, Chennai, 600089 India.
authors.forename: V B
authors.initials: VB
authors.lastname: Krihnakumar Raja
authors.affiliation: Department of Oral and Maxillofacial Surgery, SRM Dental College, Ramapuram, Chennai, 600089 India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Mohan
authors.affiliation: Tagore Dental College, Chennai, India.
authors.forename: Lokesh
authors.initials: L
authors.lastname: Bhanumurthy
keywords: Free fibular flap; Free flaps; Mandibular reconstruction; Microvascular anastomosis; Microvascular couplers; Microvascular surgery; Reconstructive microsurgery