Efficacy of Microvascular Couplers for Venous Micro-anastomosis in the Reconstruction of Oral Defects.

Background: Head and neck tumors often result in extensive maxillofacial defects requiring complex reconstructive procedures. Free tissue transfer has become the gold standard for reconstruction due to its ability to provide optimal tissue matching, functional restoration, and aesthetic outcomes. The success of free flap reconstruction depends on effective microvascular anastomosis, particularly venous anastomosis. Purpose: This study evaluates the efficacy of coupler devices for venous anastomosis in free flap reconstruction of oral defects. These devices, which use a pin-based connection system, are compared with traditional hand-sewn techniques regarding patency, operative time, and complication rates. Methods: A prospective analysis was conducted on patients undergoing free flap reconstruction for oral defects. The study assessed the use of coupler devices in anterolateral thigh, fibular, and radial forearm flaps. Primary outcomes included venous patency rates, intraoperative time reduction, and postoperative complications such as thrombosis or flap failure. Results: Preliminary findings suggest that coupler devices reduce venous anastomosis time and provide comparable or improved patency rates compared to traditional sutured anastomosis. Additionally, a lower incidence of thrombosis was observed in coupler-assisted anastomoses. Conclusion: Coupler devices offer a reliable and efficient alternative for venous anastomosis in free flap reconstruction of oral defects. Their use may contribute to reduced surgical time and improved anastomotic outcomes, making them a valuable tool in microvascular reconstruction.