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Do two venous anastomoses decrease venous thrombosis during limb reconstruction?
Raquel Iamaguchi1, Felipe Burgos1, Gustavo Silva1
1Hand Surgery and Reconstructive Microsurgery Group of the Institute of Orthopedics and Traumathology, Clinics Hospital of University of Sao Paulo, São Paulo, Brazil.
Clinical Hemorheology and Microcirculation
|April 23, 2019
Summary
For limb reconstruction with anterolateral thigh (ALT) free flaps, using two venous anastomoses significantly reduces the risk of venous thrombosis compared to one. This improves outcomes in microsurgical soft tissue reconstruction.
Area of Science:
- Microsurgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- The optimal number of veins for anastomosis in perforator flaps for limb reconstruction is debated.
- Venous thrombosis is a frequent complication in microvascular anastomoses for soft tissue reconstruction.
Purpose of the Study:
- To assess the impact of utilizing two venous anastomoses on venous thrombosis rates in anterolateral thigh (ALT) microsurgical free flaps for limb reconstruction.
Main Methods:
- A cross-sectional study included 38 patients undergoing limb reconstruction with ALT flaps (2014-2017).
- Patients were divided into two groups: one venous anastomosis (n=17) and two venous anastomoses (n=21).
- Perioperative data and complications were analyzed.
Main Results:
- The group with one venous anastomosis had a higher complication rate (47% vs. 24%) and a significantly higher rate of venous anastomotic thrombosis (p=0.032).
- The overall flap success rate was 92%.
Conclusions:
- Employing two venous anastomoses in ALT free flaps for limb reconstruction is linked to a reduced incidence of venous thrombosis.
- This technique may enhance the success of microsurgical soft tissue reconstruction.
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