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J Reconstr Microsurg 2004; 20(5): 399-403
DOI: 10.1055/s-2004-830004
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Irrigation Pressure and Vessel Injury During Microsurgery: A Qualitative Study

Ji-Geng Yan1 , N. John Yousif2 , William W. Dzwierzynski1 , Hani S. Matloub1 , James R. Sanger1 , Imad E. Shehadi1 , Kenneth A. Siegesmund3
  • 1Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee
  • 2Aesthetic and Reconstructive Surgery Associates, Waukesha, WI
  • 3Department of Anatomy, Medical College of Wisconsin, Milwaukee
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Publication History

Accepted: 1 March 2004

Publication Date:
06 July 2004 (online)

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Irrigation solution is routinely used in microsurgery. While the anticoagulation solution may aid in anastomotic patency, the direct effect of pressure irrigation can have a detrimental effect on the vessel. An experimental study was performed to determine the effect of irrigation pressure on the vessel wall. Histological evaluation with hematoxylin and eosin (H&E) stain and scanning electron microscopy (SEM) was performed on the arteries of New Zealand white rabbits irrigated with lactated Ringer's solution at pressures of 80 mmHg, 100 mmHg, and 500 mmHg. H&E staining and SEM microscopy demonstrated injury to the endothelial cells and internal elastic lamina at pressures of 100 mmHg or greater. Controlling microsurgical irrigation pressure to less than 100 mmHg may help to avoid vessel injury.

KEYWORDS

Irrigation pressure - vessel wall - endothelial damage

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William W DzwierzynskiM.D. 

Dept. of Plastic and Reconstructuve Surgery, Medical College of Wisconsin

9200 W. Wisconsin Ave.

Milwaukee, WI 53226