Preliminary report of the use of a microvascular coupling device for arterial anastomoses in oral and maxillofacial reconstruction

Abstract Our aim was to record our preliminary use of a microvascular coupler for arterial anastomoses with free flap transfer in the reconstruction of oral and maxillofacial defects in 45 patients with oral and maxillofacial defects that were repaired with anterolateral thigh, fibular, and radial forearm flaps. The microvascular coupler was used for both the venous and the arterial anastomoses. The site of the defect, type of flap, recipient artery, duration of operating time for the anastomosis, size of coupler, and survival of the flap were recorded and analysed. A total of 45 consecutive patients had microsurgical reconstructions in the head and neck, including 16 radial forearm, 18 fibular, and 11 anterolateral thigh free flaps. The sizes of coupler required ranged from 1.5-2.5 mm, with most flaps (n = 30) requiring a 2.0 mm coupler. The mean (SD) operating time for arterial anastomoses was 7 (2) mins. One arterial crisis occurred during an operation, and required a sutured anastomosis instead. There were no complications related to the technical performance of the coupler. The coupler is reliable for arterial anastomoses of free tissue transfers in reconstructions of the head and neck. With proper selection of vessels and enough experience in using the microvascular coupler, it may be used in an expeditious, safe, and reliable fashion with minimal morbidity. Though not common, the use of the coupler for arterial anastomoses saves a lot of time, and is a viable alternative to a sutured anastomosis.