Venous Coupler for Extremity Free-Flap Reconstruction

Abstract

　Free-flap reconstruction is essential for managing soft tissue defects of the extremities with exposed bone or tendon. Vascular anastomosis is a particularly challenging procedure in free-flap reconstruction, and hand-sewn venous anastomosis is considered more difficult than arterial anastomosis. Venous thrombus is a more common cause of flap necrosis than arterial complications. Thus, achieving a secure venous anastomosis is critical for improving the survival rate of free flaps.
　Venous couplers are microvascular devices widely used for venous anastomosis in free-flap reconstruction after cancer resection and trauma. These devices streamline venous anastomosis, thereby reducing procedure time. When an anastomotic microvascular device is used for anastomosis in free-flap reconstruction, an additional fee of 2,500 points can be calculated, except in extremity reconstruction cases. In our experience of 19 cases using anastomotic microvascular devices for extremity reconstruction following extremity trauma and malignant tumor resection, we observed no vascular complications related to the devices. Herein, we report our findings of the usefulness of anastomotic microvascular devices for extremity reconstruction.