Principles of Microvascular Surgery.

Endothelial Damage
• Margic, PRS 1985 - dissection and exposure of
vessels from their beds.
• Bipolar coagulation too close to the branch
origin.
• Dryness - exposed vessels should be kept in
moist environment.
• Prolonged vasospasm, more then 2h.
• Injury from microvascular clips.
• Needles and suture penetration + technique of
placement.
Injury from microvascular clips
• Directly related to clip pressure.
• Curved or angled clip cause more damage than
flat clip.
• Closing pressures should remain below 30
gr/mm 2 .
Balloons
Granulocyte
Crater-like defect
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