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Evaluation of Longitudinal Slit Arteriotomy for End to Side Anastomosis in Free Tissue Transfer

    Authors

    1 Plastic and Reconstructive Surgery Dept. , Iraqi Board of Medical Specializations, Baghdad, Iraq.

    2 Plastic and Reconstructive Surgery Dept., Iraqi Board of Medical Specializations, Baghdad, Iraq.

,

Abstract

BACKGROUND:
The choice of micro-anastomosis technique (end to end or end to side) in free flap surgeries is                      a critical step especially in single vessel extremity in which end to side is the preferable method. Which type of end to side (arteriotomy or arteriotomy) is another relevant point to be considered?
AIM:
This study aims to evaluate the reliability of end to side anastomosis using longitudinal slit arteriotomy.
METHODS:
(9) patients were managed with free tissue transfer using end to side anastomosis with longitudinal slit arteriotomy. (8) Patients with lower extremity defects and (1) patient with upper extremity defect. (6) Patients were managed with Latissimus dorsi flap and (3) patients were managed with ALT flap. In all cases end to side anastomosis is made using no. 11 blade to create a longitudinal slit in the recipient artery for micro-anastomosis
RESULTS:
All anastomosis remain patent and flaps survived without complications, neither re-anastomosis is required intra-operatively nor re-exploration is required post operatively
CONCLUSION:
longitudinal slit arteriotomy is easy to perform, reliable with high patency rate and can consistently be used in free tissue transfer with excellent results

Keywords

References
  1.  Heidekrueger PI, Ninkovic M, Heine-Geldern A, Herter F, Broer PN. End-to-end versus end-to-side anastomoses in free flap reconstruction: single centre experiences. Journal of plastic surgery and hand surgery. 2017 ;51: 362-65.
  2.  Barros RS, Leal RA, Teixeira RK, Yamaki VN, Feijó DH, Gouveia EH,  Valente AL, Silva Feitosa-Junior DJ, Carvalho LT. Continuous versus interrupted suture technique in microvascular anastomosis in rats. Acta cirurgica brasileira. 2017;32:691-96.
  3. 3.     Hsieh YH, Lee CH, Kwon SH, Chang TN. Chang’s Technique of Sequential End-to-Side Microvascular Anastomosis. International Microsurgery Journal (IMJ). 2017.
  4. 4.     Mania Z Siemionow, Manta Eisen man-klein. Plastic and reconstructive surgery, 1st ed, springer-relog London limited, 2010:94.
  5. 5.     Jeffrey E Janes. Essential of plastic surgery, 2nd ed, DMP CRC, New York, 2014:75,80,81.
  6. 6.     Tan BK, Wong CH, Chew W, Hong SW. Use of the slit arteriotomy for end-to-side arterial anastomosis in free-tissue transfers to the extremities. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2009;62:1519-23.
  7. 7.     Gu H, Chua A, Tan BK, Hung KC. Nonlinear finite element simulation to elucidate the efficacy of slit arteriotomy for end-to-side arterial anastomosis in microsurgery. Journal of biomechanics. 2006;39:435-43.
  8. 8.     Hallock GG, Rice DC. Use of a micropunch for arteriotomy in end-to-side anastomosis. Journal of reconstructive microsurgery. 1996;12:59-64.
  9. 9.     El Rifaï S, Boudard J, Haïun M, Obert L, Pauchot J. Tips and tricks for end-to-side anastomosis arteriotomies. Hand surgery and rehabilitation. 2016;35:85-94.

10. Tsai YT, Lin TS. The suitability of end-to-side microvascular anastomosis in free flap transfer for limb reconstruction. Annals of plastic surgery. 2012 ;68:171-4.

11. Godina M. Preferential use of end-to-side arterial anastomoses in free flap transfers. Plastic and reconstructive surgery. 1979;64:673-82.

12. Fu-Chan wei, Samir Mardini. Flaps and reconstrctvesurgery, 1st ed, Saurters Elsenier, 2009:59, 64, 121.

13. Pafitanis G, Veljanoski D, Ghanem AM, Myers S. Intimal surface suture line (end-product) assessment of end-to-side microvascular anastomosis. Plastic and Reconstructive Surgery Global Open. 2017;5.

14. Diego Marre. Fndemental topics in plastic surgery, 1st ed, Thieme, New York, 2018;347

15. Dash H, Kononov A, Maloney J, Browne E. A simple arteriotomy method for microsurgical end-to-side anastomoses: technical aspects of use in training and laboratory applications. Journal of reconstructive microsurgery. 1993;9:381-4.

Iraqi Postgraduate Medical Journal
Volume 20, Issue 3
July 2021
Page 277-284
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