Free-tissue transfer with the aid of loupe magnification: Experience with 251 procedures

Saleh M. Shenaq, Michael J Klebuc, Daniel Vargo

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Eight years ago, the principal author (Shenaq) began employing high-power ocular loupes for microvascular anastomoses. Subsequently, 251 free-tissue transfers were performed with loupes as the sole means of magnification. Procedures included free flaps, toe-to-hand transfers, and digital replantations, with the external diameter of the vascular pedicles averaging 1.5 mm. Analysis of the series revealed a 97.2 percent overall success rate, a 1.2 percent partial flap necrosis rate, and an 8.3 percent revision rate for anastomoses (during the initial operative procedure), which compare favorably with the success rates frequently cited for microscope-assisted procedures. The most favorable results were achieved with free flaps and toe- to-hand transfers with 98.5 and 96.4 percent success rates, respectively. The 79.2 percent survival rate achieved with digital replantation falls within the range (74.0 to 94.2 percent) reported in the literature. This experience indicates that in practiced hands, high-power ocular loupes provide an alternative to the operating microscope for microvascular anastomosis of vessels 1.0 mm or greater in diameter. Loupe use is advocated on the grounds of cost-effectiveness, portability, and operator freedom.

Original languageEnglish (US)
Pages (from-to)261-269
Number of pages9
JournalPlastic and Reconstructive Surgery
Issue number2
StatePublished - Feb 1995

ASJC Scopus subject areas

  • Surgery


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