| Microvascular Anastomosis with Non-penetrating Vascular Clips in Head and Neck Free Flap Surgery |
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Hak Chang, M.D., Kyung Won Minn, M.D., Woo Ram Kim, M.D.*, Hyun Woo Shin, M.D.*, Kyung Suck Koh, M.D.* |
| 두경부 유리피판 수술에 있어서의 비천공성 혈관 클립을 이용한 미세혈관 문합술 |
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장학·민경원·김우람*·신현우*·고경석* |
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| Abstract |
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Microvascular anastomosis with suture technique is a basic skill but there are several problems such as stenosis, thrombosis and long operating time. Recently plastic surgeons have developed non-suturing mechanical coupling devices for microvascular anastomosis. The authors applied non-penetrating vascular clips (VCS clips) in the field of free flap surgery of head and neck area. Between August of 2004 and January of 2005, we performed 9 free flaps (16 vessels) using smallsized VCS clips. Four stay sutures were applied first and then VCS clips were placed between sutures about 1 mm apart. Vascular pedicle of free flap included the descending branch of lateral circumflex femoral vessel, thoracodorsal vessel, deep inferior epigastric vessel and cephalic vein. The recipient vessels were the superior thyroid artery, superficial temporal artery, internal jugular vein, external jugular vein, and superficial temporal vein. We performed 13 end-to-end (4 arteries and 9 veins) and 3 venous end-to-side anastomoses. No flap related complication occurred but we applied additional clips or sutures in two cases due to blood leakage after completion of anastomosis. Primary patency rates seemed to be good and more rapid anastomosis could be done than conventional suture technique. Advantages of VCS technique are high patency rate, low thrombogenecity and rapidity. Although the high cost of VCS instrument may be a problem, this clip could be applied safely in microvascular free tissue transfer. |
| Key Words:
장학<, br>, 서울특별시 종로구 연건동 2 8번지 서울대학교 의과대학 성형외과학교실<, br>, Tel: 82-2-2072-3086, Fax: 82-2-3675-7792, E-mail: <, a href=", mailto:hchang@snu.ac.kr" |
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