Reduced venous thrombosis and re-exploration time with anastomotic coupling device: A cohort study

Reduced venous thrombosis and re-exploration time with anastomotic coupling device: A cohort study

Objective In the anastomotic coupling device literature, no comparative study has reported operative times, included consecutive patients, or used a matched comparison group. Our objective was to analyze patency and operative time in free flaps with venous anastomoses performed with ACD versus hand‐...

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Veröffentlicht in:Microsurgery 2016-07, Vol.36 (5), p.372-377
Hauptverfasser: Coroneos, Christopher J., Voineskos, Sophocles H., Heller, Adrian M., Avram, Ronen
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container_issue 5
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container_title Microsurgery
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creator Coroneos, Christopher J.
Voineskos, Sophocles H.
Heller, Adrian M.
Avram, Ronen
description Objective In the anastomotic coupling device literature, no comparative study has reported operative times, included consecutive patients, or used a matched comparison group. Our objective was to analyze patency and operative time in free flaps with venous anastomoses performed with ACD versus hand‐sewn. Methods: For consecutive free flaps, re‐explorations and complications were reviewed in duplicate. Operative times for ACD versus hand‐sewn were compared for: (1) matched unilateral DIEPs, and (2) re‐explorations. Results: Overall, 147 ACD and 144 hand‐sewn flaps were included. Venous thrombosis was significantly lower with ACD (1/147[1%] vs.9/144[6%], P 
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Our objective was to analyze patency and operative time in free flaps with venous anastomoses performed with ACD versus hand‐sewn. Methods: For consecutive free flaps, re‐explorations and complications were reviewed in duplicate. Operative times for ACD versus hand‐sewn were compared for: (1) matched unilateral DIEPs, and (2) re‐explorations. Results: Overall, 147 ACD and 144 hand‐sewn flaps were included. Venous thrombosis was significantly lower with ACD (1/147[1%] vs.9/144[6%], P &lt; 0.01). There was no difference in re‐exploration for venous insufficiency, or overall re‐exploration. Re‐exploration time was significantly shorter with ACD (69mins vs.205mins, P = 0.009). Conclusions: ACD significantly decreases venous thrombosis compared to hand‐sewn veins, and significantly shortens re‐exploration time. Outcomes allow an estimate of cost utility for the ACD in decreasing venous thromboses and shortening re‐exploration time. © 2015 Wiley Periodicals, Inc. Microsurgery 36:372–377, 2016.</description><identifier>ISSN: 0738-1085</identifier><identifier>EISSN: 1098-2752</identifier><identifier>DOI: 10.1002/micr.30017</identifier><identifier>PMID: 26716397</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><ispartof>Microsurgery, 2016-07, Vol.36 (5), p.372-377</ispartof><rights>2015 Wiley Periodicals, Inc.</rights><rights>2016 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4987-d21ae244bc9f4bafbfededd44361c8069881041e5eda3989471070deb1a4fb153</citedby><cites>FETCH-LOGICAL-c4987-d21ae244bc9f4bafbfededd44361c8069881041e5eda3989471070deb1a4fb153</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmicr.30017$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmicr.30017$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26716397$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coroneos, Christopher J.</creatorcontrib><creatorcontrib>Voineskos, Sophocles H.</creatorcontrib><creatorcontrib>Heller, Adrian M.</creatorcontrib><creatorcontrib>Avram, Ronen</creatorcontrib><title>Reduced venous thrombosis and re-exploration time with anastomotic coupling device: A cohort study</title><title>Microsurgery</title><addtitle>Microsurgery</addtitle><description>Objective In the anastomotic coupling device literature, no comparative study has reported operative times, included consecutive patients, or used a matched comparison group. Our objective was to analyze patency and operative time in free flaps with venous anastomoses performed with ACD versus hand‐sewn. Methods: For consecutive free flaps, re‐explorations and complications were reviewed in duplicate. Operative times for ACD versus hand‐sewn were compared for: (1) matched unilateral DIEPs, and (2) re‐explorations. Results: Overall, 147 ACD and 144 hand‐sewn flaps were included. Venous thrombosis was significantly lower with ACD (1/147[1%] vs.9/144[6%], P &lt; 0.01). There was no difference in re‐exploration for venous insufficiency, or overall re‐exploration. Re‐exploration time was significantly shorter with ACD (69mins vs.205mins, P = 0.009). Conclusions: ACD significantly decreases venous thrombosis compared to hand‐sewn veins, and significantly shortens re‐exploration time. Outcomes allow an estimate of cost utility for the ACD in decreasing venous thromboses and shortening re‐exploration time. © 2015 Wiley Periodicals, Inc. 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title Reduced venous thrombosis and re-exploration time with anastomotic coupling device: A cohort study
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