Background: The multiple-U technique is a new method for microvascular anastomosis that allows for easy and stable intima to intima contact, which is crucial for a successful procedure. The present work aimed to compare between the multiple u technique and simple interrupted suture technique regarding the patency, time needed for anastomosis, duration of bleeding after declamping and blood leakage.

Methods: In an experimental study, forty adult male albino rats with average weight 200-350 gm were subjected to femoral artery anastomosis, were split into two equal groups (n=20): Simple Interrupted Suture in one group and Multiple-U technique in another group. The milking test was done for assessment of the patency of the repaired vessel after anastomosis. Assessment of anastomosis time, anastomotic leakage, bleeding time and vessel diameter were done.

Results: Regarding the anastomotic leakage, the Multiple –U technique leakage's (6 -18 ml ) was less than leakage of the Simple Interrupted suture technique (7.5 - 24 ml). Regarding vessel diameter after anastomosis there was a significant decrease of Vessel Diameter in Simple interrupted suture technique (1.7 – 1.9 mm) when compared with Multiple U-technique (1.9 – 2.17 mm) (p= 0.017). Regarding Patency rate and anastomosis time, our results showed non-significant differences between the two techniques.

Conclusion: Multiple-U technique led to significant decrease in bleeding time and vessel diameter after anastomosis therefore our recommendation is to use Multiple-U technique particularly in digital replantation and in cases who have high risk for vessel occlusion.