Double thread suspension: A novel technique
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Microvascular free tissue transfer has become a mainstay for head and neck reconstruction, and vascular anastomosis is 1 of the most challenging aspects. This study presents a newer technique that facilitates end-to-side venous anastomosis with a microvascular coupling device in head and neck reconstruction.

This study aimed to explore a safe, convenient, and efficient technique for end-to-side venous anastomosis using the coupling device.

Researchers evaluated a novel surgical strategy, double thread suspension(DTS), by reviewing data collected in a consecutive series of 60 patients who underwent free tissue grafting after surgical resection of head and neck tumors. Patients who underwent end-to-side microvascular anastomosis using microvascular coupler device were randomly divided into the DTS group(n=30) and the traditional procedure group(TRA, n=30), the demographic data, coupler size, anastomosis time, microvascular complications, and flap survival were determined.

--The optional size range of coupler devices in the DTS group is better than that of the conventional group, ranging from 1.5 to 4.0mm compared with 2.0mm to 4.0mm.

--The average anastomosis time was 4.68±0.43 min in the DTS group which was significantly lower than the conventional group that was 9.24±1.46 min.

--There was no statistically significant difference between the 2 groups in Coupler-related complications or flap survival.

In particular, the novel DTS technique provides the advantages of lowering procedure complexity, reducing operative time, and preventing tearing of vessel wall, therefore making DTS-guided end-to-side anastomosis a safe, relatively straightforward, and reliable technique.

Journal of Oral and Maxillofacial Surgery
Source: https://doi.org/10.1016/j.joms.2021.03.012
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