title: Acute adverse effects of blunt adventitial stripping.
abstract: The adventitia is routinely removed from small arteries before the anastomosis, but the microcirculatory response to this maneuver has not been documented. We have used a rat cremaster muscle flap model for intravital microscopy to compare at the microcirculatory level the effect of blunt (n = 18) and sharp (n = 18) adventitial removal with unmanipulated control arteries (n = 18). Blunt stripping resulted in transient but significant reductions in the red cell velocity (50%, p < 0.05) and capillary perfusion (91%, p < 0.05). Sharp dissection did not affect red cell velocity; however, capillary perfusion was transiently reduced by 25% (p < 0.05). In this study, sharp adventitial dissection was found to be a less harmful method of small arteries preparation for microvascular anastomosis.
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of Utah Medical Center, School of Medicine, Salt Lake City.
authors.forename: R
authors.initials: R
authors.lastname: Lohman
authors.forename: M
authors.initials: M
authors.lastname: Siemionow
authors.forename: W B
authors.initials: WB
authors.lastname: Rockwell
authors.forename: G D
authors.initials: GD
authors.lastname: Lister
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D001158:Arteries / Q000473:pathology / Q000601:surgery; D008297:Male; D008833:Microcirculation / Q000473:pathology / Q000503:physiopathology; D018715:Microscopy, Video; D008866:Microsurgery / Q000379:methods*; D018482:Muscle, Skeletal / Q000098:blood supply*; D051381:Rats; D017207:Rats, Sprague-Dawley; D013524:Surgical Flaps / Q000379:methods* / Q000473:pathology