Division of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Beirut Arab University, Beirut, Lebanon.
Plastic Surgery Division, St George Hospital University Medical Center, Beirut, Lebanon; Plastic Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, University of Lausanne, Switzerland.
Br J Oral Maxillofac Surg. 2021 Jan;59(1):16-20. doi: 10.1016/j.bjoms.2020.06.019. Epub 2020 Jul 1.
While a simple interrupted sutured anastomosis remains the gold standard in microsurgery, the introduction of the microanastomotic coupler device (MACD) has decreased procedure time and thrombosis risk, and improved the patency of venous anastomoses. The aim of this review is to update the evidence-based advantages of the MACD on arteries, based on clinical and experimental data, and to compare them to the hand-sewn approach in free flap transfer. All relevant articles that appeared in the PubMed and Medline/Ovid databases during the past three decades were reviewed. After exclusions, 11 studies were retained and discussed. The MACD had a generally shorter arterial anastomosis time, with improved flap survival and reduced ischaemia compared with the hand-sewn approach. The use of the MACD in arterial anastomosis is an efficient and less time-consuming alternative to the hand-sewn technique, provided that the selection of vessels is appropriate and the vessel diameter is large enough to do the anastomosis.
虽然简单的间断缝合吻合术仍然是显微外科的金标准，但微吻合器（MACD）的引入降低了手术时间和血栓形成风险，提高了静脉吻合的通畅率。本综述的目的是根据临床和实验数据，更新 MACD 在动脉吻合方面的循证优势，并将其与游离皮瓣转移中的手工缝合方法进行比较。回顾了过去三十年中在 PubMed 和 Medline/Ovid 数据库中出现的所有相关文章。排除后，保留并讨论了 11 项研究。与手工缝合方法相比，MACD 通常具有更短的动脉吻合时间，皮瓣存活率更高，缺血时间更短。在适当选择血管且血管直径足够大以进行吻合的情况下，MACD 在动脉吻合中的应用是一种比手工缝合技术更有效且耗时更少的替代方法。
