“…With this approach, flap harvesting itself would not consume any additional operating time other than the time required for anastomosing additional vessels. Anastomoses of vessels reportedly require 22 min (arterial anastomosis) or 25 min (venous anastomosis) by manual suture, and can be reduced to 5 min using an anastomotic venous coupling device (Grewal, Erovic, Strumas, Enepekides, & Higgins, ; Rozen, Whitaker, & Acosta, ; Zeebregts, Acosta, Bolander, van Schilfgaarde, & Jakobsson, ). That is, this procedure requires an additional 47 min with manual suture, or 27 min with a coupling device to complete the anastomosis of an additional artery and vein.…”