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-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 < 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.