Download PDF
J Reconstr Microsurg 2006; 22(8): 631-640
DOI: 10.1055/s-2006-956237
TECHNICAL INNOVATION

Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

End-to-End Microvascular Anastomosis in the Rat Carotid Artery Using Continuous Horizontal Mattress Sutures

Tekin Şimşek1 , Lűtfi Eroglu1 , M. Sinan Engin1 , Sűleyman Kaplan2 , Levent Yildiz3
  • 1Department of Plastic, Reconstructive and Aesthetic Surgery, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
  • 2Department of Histology and Embriology, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
  • 3Department of Pathology, Ondokuz Mayis University Medical Faculty, Samsun, Turkey
Further Information

Publication History

Accepted: June 9, 2006

Publication Date:
30 November 2006 (online)

Also available at
    Permissions and Reprints

ABSTRACT

This paper reports a continuous horizontal mattress suture technique with advantages such as decreased time for anastomosis, minimized anastomotic leakage, eversion around the vessel edges, and other advantages which the continuous anastomosis technique has. This technique was compared with the classical interrupted and classical continuous suture techniques on a total of 59 Sprague-Dawley rat common carotid arteries: Group 1 (n = 19), interrupted suture technique; Group 2 (n = 20), standard continuous technique, and Group 3 (n = 20), continuous horizontal mattress technique. Early (30 min) and late (21 days) patency rates, anastomosis time, leakage on clamp release, oozing duration, additional sutures needed, and total number of sutures placed were statistically compared between groups. Specimens were taken at the 21st day randomly, and light microscopy (LM), scanning electron microscopy (SEM), and angiographic studies were performed. Results revealed that the continuous mattress suture technique has the advantages of providing a water-tight anastomosis with less suture materials in a shorter time, and minimal intraluminal suture material which can incite thrombosis. On the other hand, a tendency to anastomotic stricture was found to be the sole disadvantage of this technique.

KEYWORDS

End-to-end anastomosis - continuous horizontal mattress suture technique - microvascular surgery

REFERENCES

  • 1 Adani A, Castagnetti C, Lagana A et al.. Proposition for a new continuous suturing technique for microvascular anastomosis: a comparative study.  Br J Plast Surg. 1988;  41 506-508
    CrossrefPubMedSearch in Google Scholar
  • 2 Chen Y X, Chen L E, Seaber A V et al.. Comparison of continuous and interrupted suture techniques in microvascular anastomosis.  J Hand Surg Am. 2001;  26 530-539
    CrossrefPubMedSearch in Google Scholar
  • 3 Cordeiro P G, Santamaria E. Experience with the continuous suture microvascular anastomosis in 200 consecutive free flaps.  Ann Plast Surg. 1998;  40 1-6
    CrossrefPubMedSearch in Google Scholar
  • 4 Firsching R, Terhaag P D, Müler W et al.. Continuous- and interrupted-suture technique in microsurgical end-to-end anastomosis.  Microsurgery. 1984;  5 80-84
    CrossrefPubMedSearch in Google Scholar
  • 5 Joos K M, Blair W F, Maynard J A. A histologic comparison of continuous and interrupted microarteriorrhaphy.  Microsurgery. 1985;  6 141-146
    PubMedSearch in Google Scholar
  • 6 Lee B Y, Thoden W R, Brancato R F et al.. Comparison of continuous and interrupted suture techniques in microvascular anastomosis.  Surg Gyn Obst. 1982;  155 353-357
    PubMedSearch in Google Scholar
  • 7 Mao K, Tang M Y, South J R. comparison of continuous with interrupted sutures in microvascular anastomosis.  Microsurgery. 1986;  7 158-160
    PubMedSearch in Google Scholar
  • 8 Schlechter B, Guyuron B. A comparison of different suture techniques for microvascular anastomosis.  Ann Plast Surg. 1994;  33 28-31
    CrossrefPubMedSearch in Google Scholar
  • 9 Sasaki A, Harii K. Everting method: a new modification to obtain reliable mikrovascular anastomosis.  Surgery. 1981;  89 558-564
    PubMedSearch in Google Scholar
  • 10 Joji S, Muneshige H, Ikuta Y. Experimental study of mechanical microvascular anastomosis with new biodegradable ring device.  Br J Plast Surg. 1999;  52 559-564
    CrossrefPubMedSearch in Google Scholar
  • 11 Turan T, Özçelik D, Kuran İ et al.. Eversion with four sutures: an easy, fast and reliable technique for microvascular anastomosis.  Plast Recondtr Surg. 2001;  107 463-470
    CrossrefPubMedSearch in Google Scholar
  • 12 Karamšrsel S, Kayıkçıoğlu A, Şafak T et al.. A new technique for microvascular anastomosis: external metallic circle.  Plast Rec Surg. 1999;  104 1059-1065
    PubMedSearch in Google Scholar
  • 13 Kirsch W M, Zhu Y H, Hardesty R A et al.. A new method for microvascular anastomosis: report of experimental and clinical research.  Am Surg. 1992;  58 722-727
    PubMedSearch in Google Scholar
  • 14 Lauritzen C. A new and easier way to anastomose microvessels.  Scand J Plast Reconstr Surg. 1978;  12 291-294
    CrossrefPubMedSearch in Google Scholar
  • 15 Vitan A, Antebi E, Levy M J et al.. A new technique for vascular anastomoses.  J Cardiovasc Surg. 1986;  27 54-57
    PubMedSearch in Google Scholar
  • 16 Yıldırım A M, Güzel M Z, Aygit A C. Z-plasty and microvascular anastomosis.  J Reconstr Microsurg. 1998;  14 117-120
    PubMedSearch in Google Scholar
  • 17 Schubert H M, Hohlrieder M, Jeske H C et al.. Bipolar anastomosis technique with removable instruments: an easy, fast and reliable technique for vascular anastomosis.  Plast Reconstr Surg. 2004;  113 961-966
    PubMedSearch in Google Scholar
  • 18 Cope C, Lee K, Stern H et al.. Use of the vascular closure staple clip applier for microvascular anastomosis in free-flap surgery.  Plast Reconstr Surg. 2000;  106 107-110
    PubMedSearch in Google Scholar
  • 19 Robbins T H. Microvascular anastomosis: vascular cuff technique.  Plast Reconstr Surg. 1991;  87 567-568
    PubMedSearch in Google Scholar
  • 20 Neblett C R, Morris J R, Thomsen S. Laser-assisted microsurgical anastomosis.  Neurosurgery. 1986;  19 914-934
    CrossrefPubMedSearch in Google Scholar
  • 21 Bowen C VA, Leach D H, Crosby N L et al.. Microvascular anastomoses. A comparative study of fibrinogen adhesive and interrupted suture techniques.  Plast Reconstr Surg. 1996;  97 792-800
    PubMedSearch in Google Scholar
  • 22 Hall W W, Wrye S W, Banducci D R et al.. Microvascular anastomosis using 2-octyl cyanoacrylate in the rat femoral artery.  Ann Plast Surg. 2000;  44 508-511
    CrossrefPubMedSearch in Google Scholar
  • 23 Chen L, Chiu D TW. Spiral interrupted suturing technique for microvascular anastomosis: a comparative study.  Microsurgery. 1986;  7 72-78
    CrossrefPubMedSearch in Google Scholar
  • 24 Eroğlu L, Gšneren E, Akbaş H et al.. Using human hair as suture material in microsurgical practice.  J Reconstr Microsurg. 2003;  19 37-39
    Thieme ConnectPubMedSearch in Google Scholar
  • 25 Harris G D, Finseth F, Buncke H J. Posterior-wall-first microvascular anastomotic technique.  Br J Plast Surg. 1981;  34 47-49
    CrossrefPubMedSearch in Google Scholar
  • 26 Acland R D. Practice Manual for Microvascular Surgery. 2nd ed. St. Louis, MO; CV Mosby Company 1989: 58-112
    Search in Google Scholar
  • 27 Krag C, Holck S. The value of the patency test in microvascular anastomosis: correlation between observed patency and size of intraluminal thrombus: an experimental study in rats.  Br J Plast Surg. 1981;  34 64-66
    CrossrefPubMedSearch in Google Scholar
  • 28 Diaz D D, Freeman S B, Wilson J F et al.. Hematoma- induced flap necrosis and free radical scavengers.  Arch Otolaryngol Head Neck Surg. 1992;  18 516-518
    PubMedSearch in Google Scholar
  • 29 De Lorenzi F, Van der Hulst R RW, Boeckx W D. VCS auto suture stapled microvascular anastomoses in lower leg free flaps.  Plast Reconstr Surg. 2002;  109 2023-2030
    PubMedSearch in Google Scholar
  • 30 Tetik C, Ünal M B, Kocaoğlu B et al.. Use of continuous horizontal mattress suture techniques in microsurgery: an experimental study in rats.  J Hand Surg Am. 2005;  30 587-595
    CrossrefPubMedSearch in Google Scholar
  • 31 Lauritzen C, Bagge U. A technical and biomechanical comparison between two types of microvascular anastomoses.  Scan J Plast Reconstr Surg. 1979;  13 417-421
    CrossrefPubMedSearch in Google Scholar
  • 32 Rutherford R B. Vascular Surgery. vol 1. 4th ed. Philadelphia, PA; WB Saunders Company 1995: 401
    Search in Google Scholar
  • 33 Malt R A, Mc Khann C F. Replantation of severed arms.  JAMA. 1964;  189 716-722
    CrossrefPubMedSearch in Google Scholar
  • 34 Buncke H J, Schulz W P. Total ear reimplantation in the rabbit utilizing microminiature vascular anastomoses.  Br J Plast Surg. 1964;  15-21
    PubMedSearch in Google Scholar
  • 35 Nieuborgh L. Assessing the patency of microvascular anastomoses.  Br J Plast Surg. 1979;  32 151-152
    PubMedSearch in Google Scholar

Tekin ŞimşekM.D. 

Gülhane Askeri Tip Akademisi, Plastik ve Rekonstrüktif Cerrahi A.D.

06018 Etlik, Ankara, Turkey