title: A pilot study demonstrating the feasibility of supermicrosurgical end-to-side anastomosis onto large recipient vessels in head and neck reconstruction.
abstract: In head and neck reconstruction using free flaps, microvascular anastomosis is commonly performed in an end-to-end fashion to relatively sizable arteries including the superficial temporal, facial, and superior thyroid arteries. With the recent developments of less invasive perforator flaps such as the superficial circumflex iliac artery perforator flap, anastomosis of smaller vessels of less than 0.8 mm diameter has become necessary; however, appropriate recipient arteries for end-to-end anastomosis are often absent. We have introduced supermicrosurgical end-to-side anastomosis to such arteries in 12 cases of head and neck reconstruction. Double-needle, short-thread microsutures were used to facilitate this procedure, and indocyanine green intraoperative angiography was used to confirm patency. All patients, except one with partial necrosis, survived. We believe that our method is a safe and reliable option for cases in which there is a discrepancy between the flap pedicle and recipient arteries.
authors: Department of Plastic and Reconstructive Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1138655, Japan. Electronic address: tiida7tky@hotmail.co.jp.
authors: Takuya
authors: T
authors: Iida
authors: Department of Plastic and Reconstructive Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1138655, Japan.
authors: Hidehiko
authors: H
authors: Yoshimatsu
authors: Department of Plastic and Reconstructive Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1138655, Japan.
authors: Takumi
authors: T
authors: Yamamoto
authors: Department of Plastic and Reconstructive Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1138655, Japan.
authors: Isao
authors: I
authors: Koshima
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D001158:Arteries / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007564:Japan; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply*; D010865:Pilot Projects; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D015203:Reproducibility of Results; D013536:Suture Techniques; D014022:Tissue Survival; D016896:Treatment Outcome
keywords: Double-needle microsuture; End-to-side anastomosis; Head and neck reconstruction; SCIP flap; Supermicrosurgery