Do two venous anastomoses decrease venous thrombosis during limb reconstruction?

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.