Objective: Microvascular anastomotic coupler has gained popularity in anastomosis surgery over the last 2 decades. However, evaluation of its impact on patency rate in upper limb replantation is barely reported. In this study, we aim to access clinical efficacy of microvascular anastomotic coupler in the application of upper limb replantation. Methods: From March 2013 to August 2015, a retrospective study was conducted in 6 consecutive patients with amputated upper limbs who underwent replantation. Among these patients, replantation was performed in 2 patients with middle upper arm amputation, 1 patient with elbow amputation, 2 with forearm amputation, and 1 with wrist disarticulation. Twenty-seven microvascular anastomotic couplers were applied in anastomosis of 2 brachial arteries, 4 ulnar arteries, 3 radial arteries, 6 cephalic veins, 4 basilic veins, 4 venae comitantes of brachial arteries, and 4 venae comitantes of ulnar arteries. Revascularization time, patency rate, complications, and viability of limbs were evaluated. Results: Patency rate of vessels in all 6 patients was 100%, and average duration of operation was 5 hours, whereas the mean time for anastomoses was 4 minutes, without postoperative vascular crisis. All replanted limbs survived after an average follow-up of 2 to 12 months; blood flow was patent and no thrombosis occurred over the site of anastomosis by Doppler vascular ultrasound. Conclusion: The microvascular anastomotic coupler serves as a powerful instrument in upper limb replantation by achieving high patency rate, high viability, and low complication rate.
