Principles of Microvascular Surgery.

More documents

Recommendations

Info

Stapling technique - anastomotic coupling systems • Clinical series - » Equal or greater patency rates. » Considerably faster. » Blair, Microsurgery 1989 - Histology - similar healing process. » Gilbert, Microsurgery 1989 - At 16 weeks postrepair coupled anastomoses are 50% stronger. Nonpenetrating microvascular stapling device • Yamamoto, Ann Plast Surg 1999 - 32
Laser anastomosis • Various experimental models and few clinical series. » Patency rate favorable. » Shorter operating time. » Limited endothelial trauma. » No suture material to induce foreign body reaction. Laser anastomosis • Wide rang <strong>of</strong> laser wavelengths - CO2, argon, neodymium:YAG, KPT and diode lasers. • Mechanism - still undefined. • Initial strength - physical factors (collagen coiling, crosslinking) not biological processes (inflammation and healing). 33
Page 1 and 2: Principles of Microvascular Surgery
Page 3 and 4: History • Malt & McKhann, 1962 -
Page 5 and 6: History • Danil & Taylor + O’br
Page 7 and 8: Basic Science Concepts in Microsurg
Page 9 and 10: Vessel Injury and Regeneration •
Page 11 and 12: Vessel Wall Healing • At the time
Page 13 and 14: Damage from needles, sutures and te
Page 15 and 16: The clotting mechanism • Platelet
Page 17 and 18: Antithrombotic therapy Heparin (con
Page 19 and 20: Antithrombotic therapy Low molecula
Page 21 and 22: Antithrombotic therapy conclusions:
Page 23 and 24: The no-reflow effect • Ames, Am J
Page 25 and 26: • Treatment - The no-reflow effec
Page 27 and 28: • Loupes… • Or microscope? Mi
Page 29 and 30: • Key sutures - Anastomotic techn
Page 31: End-to-end, end-to-side and end-in-
Page 35 and 36: Monitoring perfusion • Doppler ul
Page 37 and 38: The influence of patient factors
Page 39 and 40: Free flaps • Twenty years ago - f
Page 41 and 42: • Free groin flap - Free flaps -
Page 43 and 44: Free flaps - fascia • Useful wher
Page 45 and 46: Free flaps - muscle • Free latiss
Page 47 and 48: Free fibula flap 47

Principles of Microvascular Surgery.

Create successful ePaper yourself

Delete template?

Save as template?