A Comparative Study on Microvascular Anastomosis of Vascularised Free Fibular Flap with Couplers and Suturing in Mandibular Reconstruction.

Introduction: Successful outcome of any vascularised free flap basically depends upon the successful restoration of circulation in the flap after anastomosis. As the flap ischemic time is the significant factor which determines the outcome of any free flaps, due consideration is given to reduce the time for anastomosis for reperfusion. The present study compares and evaluates whether the usage of microvascular couplers with the conventional suturing reduce the ischemic time of the free flaps.

Materials And Methods: Thirty patients were randomly divided into two groups (each group consisting of 15 patients) for mandibular reconstruction using free fibular microvascular flap. In group 1, microanastomosis was done with conventional suturing whereas microvascular couplers were used in group 2. Intraoperatively, patency, leakage and tissue perfusion were assessed. The time taken for anastomosis (time taken for suturing and applying couplers) and flap ischemic time (from the time of flap division from the donor site till the flap is reperfused after anastomosis) were calculated for both the groups.

Results: Significant decrease in time for anastomosis was observed in group 2, which resulted in decrease in flap ischemic time and in overall operating time.