microvascular suturing technique

We describe a basic yet fundamental method of performing an arteriotomy, the “crater” technique… springer. Sheng‐Mou Hou M.D. In order to avoid those problems, a new way of tying a microsuture was developed. 2017 Sep;32(9) :691-696. Kim E, Singh M, Akelina Y, Shurey S, Myers SR, Ghanem AM. The time taken for anastomosis (time taken for suturing and applying couplers) and flap ischemic time (from the time of flap division from the donor site till the flap is reperfused … Division of Orthopaedic Surgery, P.O. Compared with microvascular clamps, silk slipknot is a cheap, easily available, less space-occupying technique while performing microvascular anastomoses … Microvascular suturing has now become routine, being performed in countless centres for microvascular surgery throughout the entire world with individual modifications to certain details. Results: University of Debrecen; Research output: Contribution to journal › Article. This section addresses the development of microsurgical suture technique for microvascular anastomosis, and continues to present the array of non-suture methods currently proposed as alternatives to standard suturing. The main challenge to a successfully patent anastomosis is intimal interposition during the standardized microvascular suturing. The histologic damages to occluded area were not significantly different in both groups. Balazs Szabo, Laszlo Fazekas, Souleiman Ghanem, Zoltan A. Godo, Jozsef Madar, Aniko Apro, Norbert Nemeth. Technical errors during arteriotomy pose a significant challenge for the microsurgical technique, making the end-to-side anastomosis prone to failure. The following section deals with the authors’ particular technique for microvascular suture in the rat aorta; modifications and their sources will be mentioned. 2014;29 Suppl 2:1-5. doi: 10.1590/s0102-86502014001400001. Microsurgery; Microvascular clamp. Y1 - 1991. The tensile-strength, elongation and elasticity measurement groups were the simple interrupted and continuous sutures with 8 and 12 stitches. In this review, the authors take a brief look at the developments of this technology through the years, with a focus on the more recent … Materials and methods 2.1. The authors innovated heel suturing on the donor vessel prior to arteriotomy (HSDA) technique from the previously … The loops are then serially cut and tied, resulting in efficiently placed … Presented at the 6th International Course on Perforator Flaps, Taipei, Taiwan, October 25–27, 2002. Effect of Microvascular Anastomosis Technique on End Product Outcome in Simulated Training: A Prospective Blinded Randomized Controlled Trial. We use cookies to help provide and enhance our service and tailor content and ads. Objective: To expedite the transition to the back wall suturing of the donor and recipient vessels during side-to-side in situ microvascular anastomosis. Box 3093, Duke … Vessels were prepared using 4 % lignocaine and clamped. The total warm ischemic time for the vascular anastomosis was not significantly different. 2. Copyright © 2021 Elsevier B.V. or its licensors or contributors. Firstly, the use of a vessel sizer to determine the size of the coupler for any individual case, with the vessel end prepared and passed through the coupling ring. Intraoperatively, patency, leakage and tissue perfusion were assessed. Femoral vessels of Sprague Dawley rats training model were used to evaluate the usefulness of 4-0 silk as a slipknot for performing arterio-arterial and veno-venous microvascular anastomoses. purely end to end, interrupted suturing technique, or the microvascular anastomotic coupling system (Synovis Micro Companies Alliance, Birmingham, AL, USA). Methods: springer. Asian J Surg. This site needs JavaScript to work properly. The sleeve-technique showed the biggest pressure drop (56±16.41 mmHg), however, it was the fastest method. Copyright © 2018. Background: Even the smallest of inadvertencies may result in disastrous results. A partially avulsed ear can be reattached through suturing or microvascular surgery, depending on the severity of the injury. Head Neck Surg. 1980 Sep-Oct;3(1):58-65. doi: 10.1002/hed.2890030111. Orthopaedic Research Laboratories, Duke University Medical Center, Durham, NC. The conventional technique of microvascular anastomosis relies on interrupted sutures that require assistance for traction. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. This rat model was designed for training in the technique of microvascular anastomosis. This section addresses the development of microsurgical suture technique for microvascular anastomosis, and continues to present the array of non-suture methods currently proposed as alternatives to standard suturing. 17.1 Microvascular … Hayhurst JW, O'Brien BM. In 1902, Alexis Carrel, a French surgeon, described the technique of triangulation for vascular anastomosis, and 10 years later he was awarded the Nobel Prize in Physiology or Medicine for his outstanding … Orthopaedic Research Laboratories, Duke University Medical Center, Durham, NC . Vascular clamps are often used during microvascular repair and anastomosis. Several techniques are known to join vessels for the anastomosis types (end-to-end, end-to-side, and side-to-side). Conclusion: The left carotid artery of 12 Sprague‐Dawley rats was sectioned and anastomoses immediately performed utilizing a new technique termed coupled suturing. High costs and inherent … Though microvascular clamps are widely used for anastomosis training, there still have several shortcomings, including the bulging, expensiveness and unavailability due to sterilization. The average diameter of the chicken femoral arteries was 3.25±0.38 mm. We demonstrate a microsurgical suture technique performed without any vascular clamp on a rat model. Meticulous dissection of the bowel and the suture technique is of great importance to avoid insufficiency. The anastomoses itself can be done with different sutures like the simple interrupted the continuous or the sleeve-technique, which is said to be easier and faster than the previous types mostly in research. Please enable it to take advantage of the complete set of features! - ref: Comparison of continuous and interrupted suture techniques in microvascular anastomosis. CrossRef Google Scholar Readers are referred to the open access atlas chapters on vascularised free fibula (FFF), radial … New devices such as the Microvascular Coupler 10 and VCS clips 11 have been developed to shorten the operating time. Published by Elsevier Ltd. All rights reserved. - in the report by Chen, et al, the authors compared continuous vs interrupted suture technique; - total thrombosis rate was 8%, but no significant patency difference was noted between the CST and the interrupted suture technique in any vessel category. Corresponding Author. However, pressure exerted by the clamps may damage the vessels, which compromises patency of vessels. This is an experimental study comparing the suturing time and patency rate of a spiral interrupted suturing technique to those of conventional interrupted and continuous suturing technique in end-to-end as well as end-to-side anastomosis. Lift up the wall you are suturing to separate it from the back wall. Vessels healed well with excellent … Laser-assisted vascular anastomosis (LAVA). 3. The continuous suture technique shows a similar patency rates than interrupted technique, however with a shorter time to perform the anastomosis. gical suture technique for microvascular anastomosis, and continues to present the array of non-suture methods currently proposed as alternatives to standard suturing. Keywords Microvascular Microarterial Anastomosis Microsurgery Suture Coupling Ring-pin Clips Adhesives Gels Stents Laser Magnets This is a … This preliminary study provides a simple and effective alternative method for microvascular anastomosis training. Continuous versus interrupted suture technique in microvascular anastomosis in rats Acta Cir Bras. Compared with microvascular clamps, silk slipknot is a cheap, easily available, less space-occupying technique while performing microvascular anastomoses training. The patients selected for the study were randomly allocated to five groups of different techniques of venous anastomosis, namely Group I (conventional microsuturing), II (fibrin sealant reinforced microsuturing), III (couplers), IV (staplers), V (Laser Assisted Vascular Anastomosis (LAVA)). Materials. Jaeger MR, Ely PB, Pires JA, Ferreira LM. Department of Orthopaedic Surgery, Affiliated First Hospital, Sun Yat‐Sen University of Medical Sciences, Guangzhou, People's Republic of China . Injury. When the posterior wall technique [Br J Plast Surg 34 (1981) 47, Plast Reconstr Surg 69 (1982) 139, Microsurgery 8 (1987) 22, J Reconstr Microsurg 15 (1999) 321] is used, the loose end of the suture may be stuck to the backside of the vessel and may be hard to grab. Methods: The running-to-interrupted microsuture technique, a modification of the previously published spiral anastomosis, is described wherein loosely thrown running sutures are placed between 2 opposed anchor stitches. A broad range of hand-sutured techniques … J Hand Surg Am. Shenaq SM, Sharma SK. USA.gov. The tensile-strength of simple interrupted suture was … NLM To minimize animal use and to create a simple but realistic training model, we developed a pulsatile perfused arteries model based on turkey carotid arteries for microvascular anastomosis training. Objective: To optimize the efficiency of microvascular anastomosis and limit brain ischemia time. The aim of this study is to introduce a simple and novel microvascular training model without use of microvascular clamps. While you are suturing, take steps to avoid going through the back wall: Have the tip of your needle pointing horizontally along the surface of the vessel, never pointing down into it. We performed the patency test immediately after microvascular anastomosis and one week after surgery. The authors used the double-suture technique in seven cases (nine anastomoses). https://doi.org/10.1016/j.bjps.2004.06.009. J Reconstr Microsurg. This rat model was designed for training in the technique of microvascular anastomosis. Are mechanical microvascular anastomoses easier to learn than suture anastomoses? Chen L, Chiu DT. Surgical procedure. A plethora of methods have been proposed for coapting microvessels, with the mainstay being hand-suturing under an operating microscope. Statistical analysis. NIH Sixty Sprage-Dawley rats, weighing 250-350 g, were obtained from and housed at the Animal House, Faculty of Medicine, Assiut University, Egypt. Spiral interrupted suturing technique for microvascular anastomosis: a comparative study. So, this study aims to comparing the continuous and interrupted suture technique in artery anastomosis in rats, … Alternative micro-arteriotomy techniques for ETS microvascular anastomosis have been previously described: transverse or longitudinal slit arteriotomies without defect, excision arteriotomies with traction suture in triangular or diamond shape, or even an excision arteriotomy with a vascular micropunch. Coupling technique comprised several key steps. We demonstrate a microsurgical suture technique performed without any vascular clamp on a rat model. YAJIMA, K, Y YAMAMOTO, K NOHIRA, et al. AU - Cheng-Da, H. AU - Sharkey, N. A. the tissue variable was exclud ed, and only the suturing technique and the sutur e material could be inv estigated. - Technique of anastomosis of larger vessels  |  [5] [6] Microvascular surgery can also be used to reattach a completely avulsed ear, [7] [8] [9] but its success rate is lower because of the need for venous drainage.  |  Grabb and Smith's Plastic Surgery. Overview; Fingerprint; Abstract. techniques in microvascular anastomosis shows that a statement cannot be made to favor either technique’s patency rate and/or ease of performance when comparing end- to-end and end-to-side configurations, mainly because there is no study in humans6. Epub 2016 Jun 15. Microsurgery. Our results support the demand for a careful and atraumatic suture technique in microvascular … Orthopaedic Research Laboratories, University of California, Davis CA. springer. end to end (ETE), end to side (ETS) and end in end (EIE), differ, beside the flow parameters, also in the succession, number and depth of the sutures as well as in the technique of suturing. The Thiel embalming technique provided flap raising procedures to be performed under realistic conditions similar to the living body. AU - Szabo, Robert M. PY - 1991. A review of vascular anastomosis with mechanical aids and nonsuture techniques. Microvascular anastomosis is a common procedure in cerebrovascular surgery. Published by Elsevier Taiwan LLC. A total of 12 Sprague Dawley rats were randomly assigned to either slipknot group or vascular clamp group. “A New Technique of Microvascular Suturing: The Chopstick Rest Technique.” BRITISH JOURNAL OF PLASTIC SURGERY 57.6 … Sufficient opportunity in routine surgery may not be available for the beginners. Would you like email updates of new search results? T1 - Coupled suturing. HHS With the conventional techniques of tying knots during microvascular anastomosis or neural suturing, time may be lost due to various reasons. Department of Orthopaedic Surgery, Affiliated First Hospital, Sun Yat‐Sen University of Medical Sciences, Guangzhou, People's Republic of China COVID-19 is an emerging, rapidly evolving situation. Coupled suturing: A new technique for microvascular anastomosis Huang Cheng‐Da M.D. Clinically, this method may be advantageous in cases where the anastomosis is being performed in a deep wound in which there is no room to turn over the microclamp. Overview; Fingerprint; Abstract. The most recent review of suture techniques in microvascular anastomosis shows that a statement cannot be made to favor either technique’s patency rate and/or ease of performance when comparing end-to-end and end-to-side configurations, mainly because there is no study in humans 6. - Technique of anastomosis of larger vessels - considerations: - prosthetic grafts - vascular shunts - initial preparation: - … An alternative technique of microvascular anastomosis. Because tangle of threads usually occurs, especially after arteriotomy c, we sometimes wasted time identifying the needle and its thread before making the first suture and tying the knot, especially in deep operative field. The suturing technique is also very important. A simple and novel technique for training in microvascular suturing in a rat model. Example sentences with "Suturing technique", translation memory. Materials and Methods . Maximize patency by avoiding constriction or suturing vessel the tissue variable was exclud ed, and only the suturing technique and the sutur e material could be inv estigated. Search for … We believe that this technique has the potential for improving the performance of microvascular anastomosis in clinical practice. Methods: Incorporation of the first suture throw from the outside to the inside of the vessel lumen with the initial stay suture at the proximal apex of the arteriotomy is described. N2 - The left carotid artery of 12 Sprague-Dawley rats was sectioned and anastomoses immediately performed utilizing a new technique termed coupled suturing. 2001;26:530–9. Acta Cir Bras. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. CONCLUSIONS: The Arista-assisted microvascular anastomosis is an alternative to the conventional suture-only method because it reduces the anastomosis time significantly and does not cause narrowing of the vessel wall. Search for more papers by this author. Compared with microvascular clamps, silk slipknot is a cheap, easily available, less space-occupying technique while performing microvascular anastomoses training. The most basic technique involves microvascular end-to-end upgraded by end-to-side anastomosis. This study compared both clinically and pathologically the continuous, sleeve and autogenous arterial cuff suturing techniques with the conventional interrupted technique in the rat femoral artery. We demonstrate a microsurgical suture technique performed without any vascular clamp on a rat model. An experimental model to retraining in microvascular suture. Search for more papers by this author.  |  Because of the traction applied and the limited space and intervals between sutures, the surgeon tends to take an inverting bite from the vessel without seeing the lumen clearly at all times during the anastomosis, which, in my view, is the most critical factor for … This article reports on a microsurgical suture technique performed … In: Aston SJ, Beasley RW, Thorne CHM, eds. Anthony V. Seaber. The practice of knots untying technique using a 10-0 nylon suture and gauze to cope with technical difficulties of microvascular anastomosis In our experience of training young neurosurgeons, practice of KUT contributes to shortening the duration of blood-flow blockage and helps mastering the technique of successful microvascular anastomosis. … The vessels were prepared as above and, 3 (8:0 ethilon) stay sutures... 2.3. Since this time, a wide range of methods have been proposed for coapt- ing microvessels, and these are still evolving today. - Suture Technique: - initial suture insertion: (inside to out) ... avoid suturing both walls together; - this is best managed by prevention; ... - ref: Comparison of continuous and interrupted suture techniques in microvascular anastomosis. Compared with microvascular clamps, silk slipknot is a cheap, easily available, less space-occupying technique … An additional histological study was performed to compare their immediate traumatic effects on vessel wall. 17.1 Microvascular … BACKGROUND:Suturing of microvascular anastomosis is still a time-consuming procedure, despite the fact that different techniques and devices were designed to reduce the operation time and increase the patency rate. Place sutures perpendicularly and with equal spacing. This rat model was designed for training in the technique of microvascular anastomosis. Huang Cheng‐Da M.D. The side-to-side in situ anastomosis for IC-IC bypass is a favorable technique for distal arterial territory revascularization, given that it remains entirely intracranial, is more anatomic, does not require graft vessel harvest, and consists of a single anastomosis as compared to the extracranial-to-intracranial bypasses. 2 This technique, however, is often considered to be … - total thrombosis rate was 8%, but no significant patency difference was noted between the CST and the interrupted suture technique in any vessel category. - ref: Comparison of continuous and interrupted suture techniques in microvascular anastomosis. Many techniques were used to reduce clamping time of the recipient vessel. Anastomoses should be water-tight with the least number of sutures. An experimental study of microvascular technique, patency rates and related factors. Neurosurgery. microvascular techniques 175 KEY POINTS 1. Comparison of continuous and interrupted suture techniques in microvascular anastomosis. purely end to end, interrupted suturing technique, or the microvascular anastomotic coupling system (Synovis Micro Companies Alliance, Birmingham, AL, USA). Microvascular anastomosis is a highly skilled surgical technique that requires the assistance of optical magnification via an operating microscope or loupes to be fully visualised and thus accomplished reasonably well. Philadelphia, PA: Lippincott Williams & Wilkins; 1997:73-77. No intraoperative vascular bleeding was found during these procedures and no thrombosis occurred postoperatively.

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