Comparison of three techniques for microvascular anastomosis in a rat model
Posted by: admin | August 01, 2009 | 0 Comments
Microvascular anastomosis of vessels with 0.5 mm or smaller diameter is a difficult process. The main challenge during this procedure is the inclusion of the posterior wall during anastomosis. Miyamoto et al performed the first comparative study of the techniques described in the literature to determine the best technique. In the end, they found that the open guide suture technique was optimal. This technique provided a clear view of the lumen. Poor visualization is one of the main reasons for inclusion of the posterior wall. In addition, the open guide suture technique is easier to learn and perform in comparison to the other reviewed techniques.
Summary Objective: The anastomosis of very small vessels (external diameter: 0.5 mm) is challenging and requires high microsurgical skill. This study aims to investigate the optimal technique for the anastomosis of very small vessels. We compared three anastomotic techniques on the basis of success rate and anastomosis time in a superficial inferior epigastric arterial flap model in rats.
Forty-five SpragueeDawley rats were divided into three groups of 15 rats. The superficial inferior epigastric artery flap was elevated, and only the artery was cut and anastomosed under magnification. The anastomosis was performed with the conventional technique, with the intravascular stenting technique or with the open guide suture technique. Flap survival was assessed on postoperative day 5, and the success rates of the groups were compared. In addition, the time required for anastomosis was compared between the groups.
All flaps survived, and success rates did not differ significantly between the groups. The average anastomosis times with the conventional technique (770.0 s) and the intravascular stenting technique (822.8 s) did not differ significantly but were significantly greater than that with the open guide suture technique (699.2 s).
Miyamoto S, Sakuraba
M, Asano T, Tsuchiya S, Hamamoto Y, Onoda
S, Tomori Y, Yasunaga Y, Harii K. Optimal technique for microvascular
anastomosis of very small vessels: comparative study of three techniques in a
rat superficial inferior epigastric arterial flap model. J Plast Reconstr Aesthet Surg. 2009 Jul 6.
[Epub ahead of print.]