E Röpke1, A Berghaus, M Bloching. 1. Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität, Halle-Wittenberg.
Abstract
BACKGROUND: Microvascular anastomosis remains one of the most critical aspects of free tissue transfer. Since microsurgical suture techniques are complicated and time-consuming, other techniques of anastomosis have been created. One of these is the ring-pin system. METHODS: Between January 1996 and October 2001, 48 patients underwent reconstruction with a free radial forearm flap. In 20 patients the venous anastomosis was carried out using a ring-pin system with end-to-end technique. The clinical results were compared to the other 28 patients in whom the anastomosis was sutured with 9-0 prolene. RESULTS: In the group using ring-pin anastomosis ( n=20), two flaps showed venous congestion within 24 h postoperatively. After revision the flaps were well perfused. In the other group with sutured vessels ( n=28), a transplant became ischemic in one patient due to venous thrombosis and had to be partly removed. The time of anastomosis was considerably shortened by the use of the ring-pin system. CONCLUSIONS: The venous end-to-end-anastomosis using the ring-pin system can be carried out relatively easily and rapidly after a comparatively short period of training. Long-term results have shown good tissue tolerance of the material and sufficient blood circulation of the grafts.
BACKGROUND:Microvascular anastomosis remains one of the most critical aspects of free tissue transfer. Since microsurgical suture techniques are complicated and time-consuming, other techniques of anastomosis have been created. One of these is the ring-pin system. METHODS: Between January 1996 and October 2001, 48 patients underwent reconstruction with a free radial forearm flap. In 20 patients the venous anastomosis was carried out using a ring-pin system with end-to-end technique. The clinical results were compared to the other 28 patients in whom the anastomosis was sutured with 9-0 prolene. RESULTS: In the group using ring-pin anastomosis ( n=20), two flaps showed venous congestion within 24 h postoperatively. After revision the flaps were well perfused. In the other group with sutured vessels ( n=28), a transplant became ischemic in one patient due to venous thrombosis and had to be partly removed. The time of anastomosis was considerably shortened by the use of the ring-pin system. CONCLUSIONS: The venous end-to-end-anastomosis using the ring-pin system can be carried out relatively easily and rapidly after a comparatively short period of training. Long-term results have shown good tissue tolerance of the material and sufficient blood circulation of the grafts.
Authors: John W Frederick; Larissa Sweeny; William R Carroll; Eben L Rosenthal Journal: Otolaryngol Head Neck Surg Date: 2013-04-12 Impact factor: 3.497