Free flap surgery—the isolation of vascularized tissue from one location for implantation at a second location—is widely used in the reconstructive microsurgery to replace large tissue defects of the head and neck, breast, etc. It is complex, often requires extended periods in the operating room, and invariably involves periods of tissue ischemia during flap harvest and implantation.
In 1986, Ostrup and Berggren first described the use of a sutureless anastomotic device designed to create end-to-end anastomoses of microvessels in the 0.8 mm–3.0 mm diameter range that dramatically reduced the time required to create microvascular anastomoses while maintaining patency rates of 98% in both arteries and veins [1]. This device, first manufactured and sold by 3M as the Unilink® System, is now manufactured and sold by Synovis MCA, a division of Baxter International. The Microvascular Anastomotic COUPLER® (COUPLER) is widely used in free tissue transfer, with published...