Principles of Microvascular Surgery.
Principles of Microvascular Surgery.
Principles of Microvascular Surgery.
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• The number is critical!!!<br />
Number <strong>of</strong> sutures<br />
» Too few - excessive bleeding and thrombus formation.<br />
» Too many - increased damage to the endothelium.<br />
• The goal - well approximated, sealed,<br />
nonbleeding union with a minimum number <strong>of</strong><br />
sutures.<br />
• Cohen, PRS - 1979 - in rat femoral vessels 8-<br />
suture anastomosis is optimal.<br />
Type <strong>of</strong> sutures<br />
• Absorbable and nonabsorbale.<br />
• Mii, J Microsurg 1980 - smoother endothelial<br />
regeneration with polyglycolic acid sutures than<br />
with nonabsorbale material.<br />
• Thiede, J Microsurg 1979 - no increased<br />
aneurysm or pseudoaneurysm formation and no<br />
vascular raptures d/t decreased mechanical<br />
endurance with polyglycolic acid or polyglactin<br />
sutures.<br />
• Most surgeons use nonabsorable sutures - nylon<br />
or prolene.<br />
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