CLINICAL-EXPERIENCE WITH THE 3M MICROVASCULAR COUPLING ANASTOMOTIC DEVICE IN 100 FREE-TISSUE TRANSFERS

The microvascular surgical anastomosis remains one of the most technic ally sensitive aspects of free-tissue transfers. To facilitate these o ften time-consuming, difficult anastomoses, various anastomotic coupli ng systems have been introduced. The 3M microvascular anastomotic coup ling device, a polyethylene ring-pin device, was found to be highly su ccessful in numerous animal studies. It has been available for use in human subjects for the last 4 years, but clinical experience remains s parse. Our clinical experience with the 3M coupler is reported in 100 free-tissue transfers. The average anastomotic time was 4 minutes. Mea n follow-up was 8.6 months, and flap survival was 100 percent. The ove rall success rate for 3M (MACD) coupler use in microvascular anastomos es is 98.4 percent (121 of 123). Nine abandoned anastomoses were conve rted to sutured anastomoses intraoperatively. The overall failure rate for 3M coupler anastomoses is 1.6 percent (2 of 123). We conclude tha t the 3M device is best suited for minimally discrepant, soft, pliable venous microvascular anastomoses and is unsuitable for end-to-side an astomoses in clinical situations. When carefully and selectively emplo yed by a trained microvascular surgeon, the 3M coupler can be a safe, fast, and reliable adjunct for free-tissue transfers.