J Reconstr Microsurg
DOI: 10.1055/s-0040-1715585
Original Article

Safety of Coupled Arterial Anastomosis in Autologous Breast Reconstruction

Mariel McLaughlin
1  College of Medicine, University of Florida, Gainesville, Florida
,
Brooke E. Porter
1  College of Medicine, University of Florida, Gainesville, Florida
,
Rachel Cohen-Shohet
2  Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida, Gainesville, Florida
,
Mark M. Leyngold
2  Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida, Gainesville, Florida
› Author Affiliations

Abstract

Background This study compares the outcomes of coupled versus hand-sewn arterial anastomosis in microvascular breast reconstruction.

Methods Retrospective chart review of breast reconstruction free flaps performed between 2013 and 2018 was conducted. Primary end points included flap loss, intraoperative arterial anastomosis revision, and operating room takeback. The decision to couple the arterial anastomosis was based on patient's age, surgeon's preference, history of radiation, and vessel quality. All anastomoses were performed under ×3.5 loupe magnification to internal mammary or thoracodorsal vessels.

Results Authors reviewed 104 free flaps; two were lost in hand-sewn group; no flaps were lost in coupled group. There was no significant difference in anastomotic revision rate between coupled and hand-sewn arterial anastomosis (p = 0.186) or return to operating room (OR) between coupled and hand-sewn flaps (p = 1.000). Reasons for takeback included venous congestion and hematoma.

Conclusion This study reflects that coupled arterial anastomosis in breast reconstruction may be safely performed without increased risk in anastomotic revision, takeback, or flap loss. Decision to couple should be based on surgeon skill, patient age and history, and assessment of flap and recipient site vasculature.



Publication History

Received: 13 April 2020

Accepted: 23 June 2020

Publication Date:
20 August 2020 (online)

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