• Archives of Reconstructive Microsurgery
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• 제24권1호
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• pp.20-23
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• 2015

Despite increased utilization of microvascular anastomotic coupler (MAC) devices, the consequences have yet to be fully explored in terms of vascular regeneration. Removal of an exposed venous coupler is described herein, documenting normal circulatory flow through the remodeled site of application. A 25-year-old man who underwent open reduction and rigid fixation elsewhere for traumatic calcaneal fracture ultimately presented with a necrotic postoperative wound. The debrided defect was treated by free thigh perforator flap, incorporating a MAC device. Three months later, the flap remained viable, but the MAC itself was exposed. Structural integrity of the vessel and blood flow were sustained as the device was carefully removed, confirming true vascular remodeling in this example of MAC usage.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.51-57
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• 2006

Free flap having been used for reconstruction of skin and soft tissue defect in various areas in a body is spreading up its application for not only functional reconstruction but also aesthetic reconstruction. Authors met with good results minimizing the demerits of anastomosis using suture through microvascular anastomotic device, hereupon, we intend to report this. We worked with 27 cases that used microvascular anastomotic device for venous anastomoses among patients who were processed free flap in our hospital. Age ranged from 12 to 63 (average 43.2), and there were 12 females and 15 males. As a result of a follow-up by 3 months - 5years (average 11.3 months), there was no particular complication in the anastomosed vein except 1 cases among 27 cases that sutured their veins through microvascular anastomotic device. Use of microvascular anastomotic device at free flap shortened the time required for vascular anastomoses to reduce ischemic time of tissue, and minimized the damage of intima during anastomoses and made easy anastomoses possible even in case the difference of diameters of blood vessels being sutured is wide. As well, even for survival rate of flap, satisfactory results were obtained compared with using suture. Consequently, it is concluded that use of microvascular anastomotic device in free flap is a useful way that can substitute existing anastomosis using suture.

• 대한기계학회논문집B
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• 제35권11호
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• pp.1139-1145
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• 2011

기존 봉합사를 이용한 미세혈관수술의 단점을 개선한 기계식 미세혈관 문합시스템은 크게 문합링-핀 시스템 및 디바이스로 구분된다. 유한요소해석을 이용한 본 연구에서 문합링파트는 생체적합성과 사출성형 가공성이 우수한 High Density Polyethylene(HDPE)가 적용되었고, 마이크로핀은 SUS316, Ti-6Al-4Nb, Ti-6Al-4V, unalloyed titanium 이상 4가지 재료가 적용되었다. 미세혈관 문합링 마이크로핀의 fillet radius, neck length가 von Mises stress 변화에 미치는 영향을 평가하기 위해 Short Neck(SN)과 Long Neck(LN)으로 구분하고, 필렛이 존재하지 않는 경우(SN-1, LN-1)와 존재하는 경우(SN-2, SN-3, LN-2, LN-3)로 구분하였다. 필렛 유무와 형상에 대한 von Mises stress의 변화비인 Fillet Radius Rate(FRR)와 동일 필렛형상 내에서 neck 길이변화에 따른 von Mises stress의 변화비인 Neck Length Rate(NLR)의 결과를 종합해본 결과 SN-3의 마이크로핀 neck 형상이 가장 안전한 설계 형상임을 파악할 수 있었다.

• Archives of Reconstructive Microsurgery
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• 제17권2호
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• pp.94-100
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• 2008

In the past decade, there has been increasing breast reconstructions after mastectomy, and the abdomen has been the gold standard for donor site. TRAM (transverse rectus abdominis myocutaneous), MSTRAM (muscle sparing transverse rectus abdominis myocutaneous), DIEP (deep inferior epigastric artery perforator), SIEA (superficial inferior epigastric artery) flap has been widely used nowadays. Among them, DIEP free flap spares the whole rectus abdominis muscle and anterior rectus sheath resulting in decreased donor site morbidity. Between March of 2006 and February of 2008, six patients had undergone immediate breast reconstructions using DIEP free flap. The mean age of patients was 48.5 years. All patients had unilateral breast reconstructions. We dissected two perforators which were included in the unilateral pedicle. Thoracodorsal artery and its venae comitantes were chosen as recipient vessels. For venous anastomosis, we used the GEM Microvascular Anastomotic Coupler System (Synovis Micro Companies Alliance, Inc., Birmingham, Ala.) in four cases. All flaps were survived completely except one who showed fatty abdomen in old age. She showed repetitive vascular spasm intraoperatively. None of the patients had abdominal hernia, bulge or weakness. We believe that DIEP free flap provides a reliable method for autologous breast reconstruction if the patients are selected appropriately and performed by a skillful surgeon.