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Arch Hand Microsurg > Volume 24(1); 2015 > Article
Archives of Hand and Microsurgery 2015;24(1):1-6.
Published online May 30, 2015.
Safety of a Single Venous Anastomosis in Anterolateral Thigh Free Flap for Extremity Reconstruction
Sang Soo Yu, Hyun Woo Shin<sup><xref ref-type="corresp" rid="cor1">*</xref></sup>, Pil Dong Cho, and Soo Hyang Lee
Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.
Received: 21 January 2015   • Revised: 11 February 2015   • Accepted: 16 February 2015


The main cause of flap loss in microsurgical tissue transfer is venous insufficiency. Whether or not multiple venous anastomoses prevents vascular thrombosis and reduces the risk of flap failure remains controversial. Some researchers are in favor of performing dual venous anastomoses, but the counterargument holds that performing a single venous anastomosis does provide advantages.

Materials and Methods:

We carried out a retrospective analysis of 15 cases of anterolateral thigh free flap for extremity reconstruction performed between January 2011 and December 2013. The patients were categorized into two groups: group A that received a single venous anastomosis and group B that received dual venous anastomoses. The time of the anastomosis, size of the flap, complications of the flap, and survival rate of each group were analyzed.


The total microsurgical time in the single venous anastomosis group ranged from 28 to 43 minutes (mean 35.9 minutes). The total time in the dual anastomoses group ranged from 50 to 64 minutes (mean 55.7 minutes). No statistically significant difference was found between the two groups with regards to postoperative complications and flap failure.


Our study suggests that the use of a single venous anastomosis in the venous drainage of anterolateral thigh free flaps is a safe and feasible option for extremity reconstruction and provides shorter operative time and easy flap dissection.

Key Words: Free tissue flaps, Surgical anastomosis, Reconstructive surgical procedures, Extremities

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