Application of the Knotting After Half-side Threaded Anastomosis Method in Free Anterolateral Thigh Flap Repair.

[PURPOSE] The anterolateral thigh (ALT) flap serves as a pivotal technique for maxillofacial defect restoration. The prognosis of free flap repair is critically tied to the quality of vascular anastomosis. In this study, we introduced the Knotted After Half-Side Threaded Anastomosis Method (KAHTAM) and conducted a comparative analysis to assess its performance in relation to the conventional Half-Side Intermittent Anastomosis Method (HIAM).

[METHODS] One hundred forty-nine cases of ALT flap repair were included, and our analysis encompassed the evaluation and comparison of variations in patients' general information, the state of the vascular lumen at the final stitch, outcomes of flap repair, complications, along with the surgical data of vascular anastomosis and the clinical data of the surgery between 2 groups.

[RESULTS] Compared with the HIAM group, the KAHTAM group exhibited a larger and more distinct vascular lumen, leading to a higher success rate and fewer postoperative complications. The KAHTAM group also showed a superior immediate patency rate after the first anastomosis and a lower rate of supplementary sutures for blood leakage during arterial anastomosis. In addition, the time for vascular anastomosis was shorter in the KAHTAM group.

[CONCLUSIONS] The utilization of KAHTAM has showcased its potential in enhancing the overall quality of vascular anastomosis and improving the success rate and efficiency of free ALT flap repair.