en تخصصي Special مقالات اصيل Original Article <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:150%"><span cambria="" style="font-family:"><b><span new="" roman="" style="font-family:" times="">Background:</span></b><span new="" roman="" style="font-family:" times=""> Free flaps are widely used for reconstructive surgery, with venous anastomosis&mdash;single or dual&mdash;being critical to flap survival. We compared outcomes between single and dual venous anastomoses.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:150%"><span cambria="" style="font-family:"><b><span new="" roman="" style="font-family:" times="">Methods:</span></b><span new="" roman="" style="font-family:" times=""> In a cross-sectional study at Hazrat Fatemeh Hospital, Tehran, Iran, 23 patients undergoing free flap surgery were grouped by venous anastomosis type. Primary outcome was flap survival; secondary outcomes included venous thrombosis, congestion, capillary refill, and reoperation. Confounding variables (age, diabetes, smoking, ASA score) showed no significant differences.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:150%"><span cambria="" style="font-family:"><b><span new="" roman="" style="font-family:" times="">Results:</span></b><span new="" roman="" style="font-family:" times=""> Patients with flap failure averaged 38 years; successful cases averaged 34.7 years. Flap success was higher in the dual anastomosis group (90%) than the single group (69.2%), though not statistically significant (P = 0.25). No moderate or severe congestion occurred in the dual group, which also had more cases of bright-colored flaps (58.2% vs. 41.2%, P < 0.05). Capillary refill times were similar across groups.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:150%"><span cambria="" style="font-family:"><b><span new="" roman="" style="font-family:" times="">Conclusion:</span></b><span new="" roman="" style="font-family:" times=""> Dual venous anastomosis may reduce venous congestion and improve flap appearance, though its effect on overall flap success and thrombosis was not statistically significant. Larger studies are needed to validate these findings.</span></span></span></span></span><br> &nbsp; Free flaps, Venous anastomosis, Flap survival, Venous congestion, Surgical outcomes 37 44 http://wjps.ir/browse.php?a_code=A-10-1052-6&slc_lang=en&sid=1 Yousef Shafaei 100319475328460017516 100319475328460017516 No Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Alireza Minouee 100319475328460017517 100319475328460017517 No Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Reza Vaghardoost 100319475328460017518 100319475328460017518 No Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Khatere Isazadehfar 100319475328460017519 100319475328460017519 No Community and Preventive Medicine, Social Determinants of Health Research Center, Medical Faculty, Ardabil University of Medical Sciences, Ardabil, Iran Shahriar Bagheri 100319475328460017520 100319475328460017520 No Medical School, Fasa University of Medical Sciences, Fasa, Iran Mohammad Dehbozorgi mdehbozorgi@hotmail.com 100319475328460017521 100319475328460017521 Yes Department of Plastic and Reconstructive Surgery, Shiraz University of Medical Sciences, Shiraz, Iran Mohammad Kashkooli 100319475328460017522 100319475328460017522 No Visiting Student, Harvard-MIT Health Sciences and Technology, Boston, MA, USA