A COMPARISON OF SUTURE VERSUS LASER-ASSISTED MICROVASCULAR ANASTOMOSIS (LAMA) IN THE PIG BUTTOCK FLAP MODEL

Introduction of microvascular free-tissue transfer to head and neck su rgery has completely altered the current approach to extirpation and r econstruction. The increased flexibility now available offers multiple options for reconstruction and has essentially removed the limitation s of size and geometry which existed with other types of repair. Despi te these advantages, increased surgical time and potential flap failur e loom as limiting factors. Since the initial use of sutures to perfor m microvascular anastomoses, numerous experiments have been conducted in order to identify other options for vessel approximation. Laser-ass isted microvascular anastomosis (LAMA) was first attempted with the ne odymium-yttrium aluminum garnet (Nd:YAG) laser and, subsequently, othe r wavelengths were used in experimental models. Success with this tech nique has been repeatedly documented. Although a comparable animal mod el to study skin flaps was initially described in 1979, little is curr ently available in the literature that describes the actual use of a m icrovascular free flap model. Certainly, nothing exists regarding the role of LAMA and microvascular free-tissue transfer. This study was de signed to establish a reliable and reproducible animal model to study free-tissue transfer. Through the use of laser Doppler flowmetry, valu es of blood perfusion of flaps can be determined. Anastomoses with sta ndard suture and various laser-assisted techniques could then be done and compared, analyzing the parameters of time and blood flow. Histolo gic evaluation could be correlated with clinical observations. In so d oing, LAMA could be objectively evaluated as a potentially viable meth od of vascular reconstruction in microsurgical free-tissue transfer.