Use of the slit arteriotomy for end-to-side arterial anastomosis in free-tissue transfers to the extremities

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
Bien-Keem TanSoo-Wan Hong

Abstract

The purpose of this study was to demonstrate the reliability and advantages of the slit arteriotomy for end-to-side arterial anastomosis. Sixty free flaps for reconstruction of the upper and lower extremities were re-vascularised using this technique. Flaps used were: gracilis (20), latissimus dorsi (18), rectus abdominis (6), lateral arm (6), fibula (3), radial forearm (4), scapular (1) and anterolateral thigh (2). A double microclamp is applied. Using a 30 degrees microknife, a longitudinal slit is made on the recipient vessel. The clamps are then approximated slightly. This slackens the segment bearing the slit and opens up the slit to facilitate placement of sutures. Beginning at the heel, interrupted sutures are placed in such a way as to feed the redundancy of the donor artery wall towards the toe of the anastomosis. A slightly oversized slit is used to stretch the donor vessel, which due to its inherent elastic recoil keeps the anastomosis patent. Once the tourniquet is released, blood flow resumes and the slit forms an elliptical opening. A video is available for viewing at our website: www.microflap.com. The arterial patency rate was 98%. The mechanical advantage of the slit arteriotomy construct was demonstrated throu...Continue Reading

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Citations

Sep 23, 2011·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Chin-Ho WongFu-Chan Wei
Apr 28, 2016·Hand Surgery and Rehabilitation·Sébastien El RifaïJulien Pauchot
Apr 2, 2015·International Journal of Surgery·Haijun Mao, Guangyue Xu
Jun 3, 2014·Archives of Plastic Surgery·Savitha RamachandranBien-Keem Tan
Jul 12, 2012·Archives of Plastic Surgery·Christopher Hoe-Kong ChuiBien-Keem Tan
Apr 27, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Makoto MotomiyaNorimasa Iwasaki

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