Important Techniques Of Vascular Anastomosis In Free Anterolateral Thigh Flaps

Objective:We summarized the free anterolateral thigh flaps proceduresperformed by our medical team during a period of time. Attempting tofind important techniques and points in the procedure.Methods:We collected37cases which applied free anterolateral thigh flapsprocedure during2013.10-2014.6. Methods consist of statisticanalysis of the relations between the intraoperative techniques andrevision rates.Results:Among37cases,76vessels were received vascular anastomosis.In the end-to-end vascular anastomosis group,70vesels survived,3vessels failed.In the end-to-side vascular anastomosis group,2sucesses with no failed;In the venous transplant group，1success andnone failed.P=0.196,no statistic difference.33vessels were dividedby whether the vascular clips was applied during the procedure.In thevascular clips group,3succeeded and0failed;In the none vascular group,26succeeded and4failed.P=0.570，no statistic difference.37vessels was divided by flushing fluid constituent.In the heparin-NSgroup,7succeeded and0failed;In the NS group:26succeeded and4failed.P=0.570,no statistic difference.37vessels were divided bywhether fibrin clot was found during the anastomosis.In the fibrinclot group,0succeeded and4failed;In the no-fibrin clot group,33succeeded and0failed.P＜0.05，There was significant difference.The revision rate of our research is8.11%,which is comparable withthe national standard(9.9%);The flap survival rate in2weekpostoperation is91.89%.While the revision success rate is0,whichresuted from late discovery for the surgery.Conclusions:Our research demonstrates that vascular anastomosis method has norelationship with flap success rates.While end-to-end anastomosis andvenous transplant are still considered important techniques to reducedonor site vessel damage and provide solutions to some greatintraoperation problems.Appling vessel clips and heprin-NS flushfluid has no significant affection to the success rates.Finding thefibrin protein has a close relationship with postoperativerevision.Once finding the fibrin we suggest to use heprinintravenously to act against the thromboplastin in the blood.