Introduction:

The anastomosis is the most critical component of free tissue transfer in head and neck reconstruction. The classical hand-sewn technique ensures high success rates. Nonetheless, it is technically demanding. In the last decades, several alternatives have been proposed, of which the coupler device has undoubtedly demonstrated the best results. We aim to compare our experience in head and neck free tissue transfer either using the hand sewn technique (HSA) or the microvascular coupler device (MVCD)

Material and methods:

A total of 89 patients met the inclusion criteria. Of these, 42 underwent the MVCD technique and 47 the HSA technique. Results in terms of flap loss and venous thrombosis were analysed.

Results:

In the first group (HSA) 3 cases of venous thrombosis were found (6,3 %). On the other hand, in the second group (MVCD) 2 cases of venous thrombosis were found (4,7 %) and 4 flaps were lost (9,5 %). In the MVCD group, the coupler size most frequently used in the anastomosis was the 2 mm coupler device (60 %).

Conclusion:

We found a lower rate of venous thrombosis in the MVCD group (4,7 % vs. 6,3 %). Nonetheless, the success rate in the HSA group regarding flap loss was higher (4,2 % vs. 9,5 % flap loss). Overall complication rate was 14,28 % in the MVCD group, compared to 14,89% in the HSA group. Interestingly, three of the four flaps lost in the MVCD group were used in reconstruction of maxillary defects (two FFF and one RFFF).

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