End-to-side Anastomosis on Digital Arteries: Just a Technical Choice or a Real Benefit?
Background:. High-quality evidence is currently poor regarding the benefits of end-to-end (ETE) or end-to-side (ETS) anastomosis in arterial and venous anastomoses, despite being postulated as a potential influence on outcomes. A sufficient microvascular anastomosis is indispensable for the success...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-09-01
|
| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004535 |
| _version_ | 1797991627681169408 |
|---|---|
| author | Luigi Troisi, MD, PhD, FEBOPRAS Erica Tedone Clemente, MD Valentina Susca, MD Macarena Vizcay, MD Francesco Zanchetta, MD Sara Stucchi, MD Giorgio Eugenio Pajardi, MD |
| author_facet | Luigi Troisi, MD, PhD, FEBOPRAS Erica Tedone Clemente, MD Valentina Susca, MD Macarena Vizcay, MD Francesco Zanchetta, MD Sara Stucchi, MD Giorgio Eugenio Pajardi, MD |
| author_sort | Luigi Troisi, MD, PhD, FEBOPRAS |
| collection | DOAJ |
| description | Background:. High-quality evidence is currently poor regarding the benefits of end-to-end (ETE) or end-to-side (ETS) anastomosis in arterial and venous anastomoses, despite being postulated as a potential influence on outcomes. A sufficient microvascular anastomosis is indispensable for the success of any free tissue transfer. ETS microvascular anastomoses have been becoming increasingly important as they allow reconstruction even in patients with impaired vascular status. To the authors’ knowledge, no studies have examined the choice of ETE or ETS anastomoses specifically for digital arteries.
Methods:. We conducted a retrospective study of ETE and ETS anastomosis cases; the only inclusion criteria was that digital arteries (proper, common) were the recipient vessels.
Results:. Fifty-seven cases met the inclusion criteria. All the venous anastomoses were ETE. Of these cases, four total intraoperative complications (immediate thrombosis) and only one case of complete failure were registered. The ETE group consisted of 49 patients and the ETS group of eight patients. A comparison of the mean ischemia time in the two groups showed no statistically significant difference (P = 0.121).
Conclusions:. We observed no difference in the reconstructive outcomes of hand free-flaps and reconstruction between ETE or ETS digital arteries anastomoses. The successful microsurgical reconstruction was independent of anastomotic technique. In particular, the results of our study demonstrated no statistically significant increase of the ischemia time; thus, no prolongation of operative time can be attributed to the higher technical challenge of the anastomosis. |
| first_indexed | 2024-04-11T08:53:54Z |
| format | Article |
| id | doaj.art-66e252a117d9487fbf2ae87b4bf9a95b |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-11T08:53:54Z |
| publishDate | 2022-09-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-66e252a117d9487fbf2ae87b4bf9a95b2022-12-22T04:33:20ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-09-01109e453510.1097/GOX.0000000000004535202209000-00044End-to-side Anastomosis on Digital Arteries: Just a Technical Choice or a Real Benefit?Luigi Troisi, MD, PhD, FEBOPRAS0Erica Tedone Clemente, MD1Valentina Susca, MD2Macarena Vizcay, MD3Francesco Zanchetta, MD4Sara Stucchi, MD5Giorgio Eugenio Pajardi, MD6From the * Reconstructive Microsurgery Service, University Department of Hand Surgery & Rehabilitation – San Giuseppe Hospital – IRCCS MultiMedica Group Milan, ItalyFrom the * Reconstructive Microsurgery Service, University Department of Hand Surgery & Rehabilitation – San Giuseppe Hospital – IRCCS MultiMedica Group Milan, Italy† School of Specialization in Plastic, Reconstructive and Aesthetic Surgery – Milan University, Milan, ItalyFrom the * Reconstructive Microsurgery Service, University Department of Hand Surgery & Rehabilitation – San Giuseppe Hospital – IRCCS MultiMedica Group Milan, ItalyFrom the * Reconstructive Microsurgery Service, University Department of Hand Surgery & Rehabilitation – San Giuseppe Hospital – IRCCS MultiMedica Group Milan, Italy† School of Specialization in Plastic, Reconstructive and Aesthetic Surgery – Milan University, Milan, ItalyFrom the * Reconstructive Microsurgery Service, University Department of Hand Surgery & Rehabilitation – San Giuseppe Hospital – IRCCS MultiMedica Group Milan, ItalyBackground:. High-quality evidence is currently poor regarding the benefits of end-to-end (ETE) or end-to-side (ETS) anastomosis in arterial and venous anastomoses, despite being postulated as a potential influence on outcomes. A sufficient microvascular anastomosis is indispensable for the success of any free tissue transfer. ETS microvascular anastomoses have been becoming increasingly important as they allow reconstruction even in patients with impaired vascular status. To the authors’ knowledge, no studies have examined the choice of ETE or ETS anastomoses specifically for digital arteries. Methods:. We conducted a retrospective study of ETE and ETS anastomosis cases; the only inclusion criteria was that digital arteries (proper, common) were the recipient vessels. Results:. Fifty-seven cases met the inclusion criteria. All the venous anastomoses were ETE. Of these cases, four total intraoperative complications (immediate thrombosis) and only one case of complete failure were registered. The ETE group consisted of 49 patients and the ETS group of eight patients. A comparison of the mean ischemia time in the two groups showed no statistically significant difference (P = 0.121). Conclusions:. We observed no difference in the reconstructive outcomes of hand free-flaps and reconstruction between ETE or ETS digital arteries anastomoses. The successful microsurgical reconstruction was independent of anastomotic technique. In particular, the results of our study demonstrated no statistically significant increase of the ischemia time; thus, no prolongation of operative time can be attributed to the higher technical challenge of the anastomosis.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004535 |
| spellingShingle | Luigi Troisi, MD, PhD, FEBOPRAS Erica Tedone Clemente, MD Valentina Susca, MD Macarena Vizcay, MD Francesco Zanchetta, MD Sara Stucchi, MD Giorgio Eugenio Pajardi, MD End-to-side Anastomosis on Digital Arteries: Just a Technical Choice or a Real Benefit? Plastic and Reconstructive Surgery, Global Open |
| title | End-to-side Anastomosis on Digital Arteries: Just a Technical Choice or a Real Benefit? |
| title_full | End-to-side Anastomosis on Digital Arteries: Just a Technical Choice or a Real Benefit? |
| title_fullStr | End-to-side Anastomosis on Digital Arteries: Just a Technical Choice or a Real Benefit? |
| title_full_unstemmed | End-to-side Anastomosis on Digital Arteries: Just a Technical Choice or a Real Benefit? |
| title_short | End-to-side Anastomosis on Digital Arteries: Just a Technical Choice or a Real Benefit? |
| title_sort | end to side anastomosis on digital arteries just a technical choice or a real benefit |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004535 |
| work_keys_str_mv | AT luigitroisimdphdfebopras endtosideanastomosisondigitalarteriesjustatechnicalchoiceorarealbenefit AT ericatedoneclementemd endtosideanastomosisondigitalarteriesjustatechnicalchoiceorarealbenefit AT valentinasuscamd endtosideanastomosisondigitalarteriesjustatechnicalchoiceorarealbenefit AT macarenavizcaymd endtosideanastomosisondigitalarteriesjustatechnicalchoiceorarealbenefit AT francescozanchettamd endtosideanastomosisondigitalarteriesjustatechnicalchoiceorarealbenefit AT sarastucchimd endtosideanastomosisondigitalarteriesjustatechnicalchoiceorarealbenefit AT giorgioeugeniopajardimd endtosideanastomosisondigitalarteriesjustatechnicalchoiceorarealbenefit |