-Original-

A Comparison of Microsurgical Venous Anastomosis Techniques

Hiroki Umezawa¹, Rei Ogawa¹, Munenaga Nakamizo², Kazuhiko Yokoshima² and Hiko Hyakusoku¹

¹Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School
²Department of Otolaryngology, Head and Neck Surgery, Nippon Medical School

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.

J Nippon Med Sch 2015; 82: 14-20

Keywords
venous anastomosis technique, microvascular anastomotic coupling device, free flap

Correspondence to
Hiroki Umezawa, MD, Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, 1-1-5 Bunkyo-ku, Sendagi, Tokyo 113-8602, Japan
s8013@nms.ac.jp

Received, August 2, 2014
Accepted, September 29, 2014