Affiliations: Hand Surgery and Reconstructive Microsurgery Group of the Institute of Orthopedics and Traumathology, Clinics Hospital of University of Sao Paulo, São Paulo, Brazil
Correspondence:
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Corresponding author: Raquel Iamaguchi, Rua Cerro Cora 1540, Sao Paulo, Sao Paulo, 05061300, Brazil. E-mail: rbiamaguchi@gmail.com.
Abstract: BACKGROUND:The optimal number of veins to be anastomosed in perforator flaps for limb reconstruction and its influence on the results remain controversial. Venous thrombosis of microvascular anastomoses is a commonly recorded complication in soft tissue reconstruction. OBJECTIVE:To evaluate the effect of two venous anastomoses in the incidence of venous thrombosis for limb reconstruction using anterolateral thigh (ALT) microsurgical free flaps. METHODS:This was a cross-sectional study on patients undergoing limb reconstruction using ALT flap during 2014–2017. Perioperative information was recorded and patients were divided in two groups: group 1 (one venous anastomosis; 17 patients) and group 2 (two venous anastomoses; 21 patients). Complications were investigated. RESULTS:Overall, 38 microsurgical flaps were included. The mean age was 33 years, and 32 patients were male. The most prevalent wounds were traumatic. Group 1 presented a higher complication rate than group 2 (47% vs. 24%; p = 0.065), although the difference was not significant. Group 1 presented a higher rate of venous anastomotic thrombosis (p = 0.032) than group 2. The overall success rate was 92%. CONCLUSION:For limb reconstruction using ALT microsurgical free flaps, two venous anastomoses are associated with a low rate of venous thrombosis in microvascular anastomoses.
