Efficacy of the microscopic parachute end-to-side technique for creating large-to-small venous anastomoses in free flaps in the extremities

Motomiya, Makoto; Watanabe, Naoya; Ota, Mitsutoshi; Shimoda, Kohei; Kawamura, Daisuke; Iwasaki, Norimasa

Efficacy of the microscopic parachute end-to-side technique for creating large-to-small venous anastomoses in free flaps in the extremities

Motomiya, Makoto; Watanabe, Naoya; Ota, Mitsutoshi et al.

JPRAS Open, 2022, 34, 189-198

Permalink : https://hdl.handle.net/2115/88646

このアイテムのアクセス数:289件（2026-01-14 07:53 集計）

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https://doi.org/10.1016/j.jpra.2022.10.003

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アクセス権	metadata only access
URI	https://hdl.handle.net/2115/88646
タイトル	Efficacy of the microscopic parachute end-to-side technique for creating large-to-small venous anastomoses in free flaps in the extremities
著者	Motomiya, Makoto ; Watanabe, Naoya ; Ota, Mitsutoshi ; Shimoda, Kohei ; Kawamura, Daisuke ; Iwasaki, Norimasa
著者名 Motomiya, Makoto
著者名 Watanabe, Naoya
著者名 Ota, Mitsutoshi
著者名 Shimoda, Kohei
著者名 Kawamura, Daisuke
e-Rad_Researcher 30322803 著者名 Iwasaki, Norimasa
言語	英語
キーワード	End-to-side anastomosis
	Free flap
	Microscopic parachute end-to-side (MPETS)
	anastomosis
	Parachute
	Venous anastomosis
	Venous valve
発行日	2022-12
出版者	Elsevier
収録物名	JPRAS Open
巻(号)	34
ページ	189-198
抄録	Purpose: The availability of reliable and suitably sized veins is limited for creating free flaps to treat severe trauma and infection, and it is important to manage vessel size discrepancy between the recipient and flap veins. We evaluated the clinical outcomes of free flaps with large-to-small venous end-to-side (ETS) anastomoses using the microscopic parachute end-to-side (MPETS) anastomosis in soft tissue defects in the extremities. This procedure comprises mainly a wide-slit venotomy and parachute procedure at the heel. Methods: We examined 24 free flaps in 23 patients given a largeto-small venous anastomosis using the MPETS technique. Patient demographics, details of vessel anastomoses, and flap outcomes and complications were obtained from medical records. Results: Two veins were anastomosed in six flaps. Thirty anastomosed veins were assessed, and 24 deep veins, all of which accompanied main arteries, were chosen as recipient veins. The mean diameters were 1.5 mm in the recipient veins and 2.7 mm in the flap veins, and the mean vessel size discrepancy was 1.8-fold (range 1.3-3.3 fold). Because of the presence of venous valves at the anastomotic site, trimming of venous cusps was performed in six veins. All flaps survived, though one venous thrombosis occurred because of pedicle kinking in a case with a short pedicle. Conclusions: The MPETS technique is simple, reliable, and useful for performing various types of venous anastomoses regardless of a vessel size discrepancy and the presence of a venous valve. This may be a good option for large-to-small venous anastomosis in free flaps. (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
PISSN	2352-5878
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1016/j.jpra.2022.10.003