The effect of exposure time on microsurgical anastomoses of experimentally crushed arteries.
Replantation after crushing amputation has a relatively low success rate. Although the mechanism of trauma is a major factor in failure, the time lapse before vessel anastomosis may also be a contributing factor. In this study, we observed the influence of the interval between vessel injury and surgical treatment on thrombus formation and healing after controlled crushing. Seventy-five Sprague-Dawley rats were used. A segment of femoral artery was clamped to create warm ischemia for 8 hours and crushed with a 15 kg load for one hour. After the loading device was removed the crushed segments were transected and the vessel ends exposed to the adjacent tissues and blood for 0, 2, 4 and 6 hours (groups II-V, respectively) prior to being anastomosed with standard microsurgical technique. The vessel samples were harvested at days 1, 2 and 7, respectively, and evaluated by light microscopy and scanning electron microscopy (SEM). The patency rate of the anastomoses was 97.3% at harvest and reendothelialization was completed at day 7. Three anastomoses with 4 or 6 hours exposure showed thrombosis, or clotting. The results indicated that up to 6 hours exposure time did not have a significant influence on thrombus formation or the healing process of vessels under the controlled conditions of this study.
Su
W F
WF
Orthopaedic Research Laboratories, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Chen
L E
LE
Seaber
A V
AV
Urbaniak
J R
JR
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D003444:Crush Syndrome / Q000473:pathology / Q000601:surgery*; D005263:Femoral Artery / Q000293:injuries / Q000473:pathology / Q000601:surgery; D006614:Hindlimb / Q000098:blood supply; D007511:Ischemia / Q000473:pathology / Q000601:surgery; D008855:Microscopy, Electron, Scanning; D008866:Microsurgery / Q000379:methods*; D009131:Muscle, Smooth, Vascular / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D051381:Rats; D017207:Rats, Sprague-Dawley; D012092:Replantation / Q000379:methods*; D013927:Thrombosis / Q000473:pathology / Q000601:surgery; D014945:Wound Healing / Q000502:physiology