Impact of poor microsurgical suture technique on tissue perfusion in a rat model.
This study was designed to evaluate the effect of poor suture technique in microsurgical small-vessel anastomosis on tissue microcirculation. Eighteen male Sprague-Dawley rats were divided into three groups of six animals each: sham control group, regular suture group (control), and inverting suture group. In the regular suture group, a standard single-stitch suture technique was used for microsurgical reanastomosis of the transected common iliac artery. In the inverting suture group, a suture technique was applied inverting the vessel wall, thus simulating poor suture technique. After 24 h, intravital microcirculatory measurements were obtained in the cremaster muscle flap. The inverting suture caused a significant drop in capillary perfusion from 6.40 (sham control) and 5.65 (regular suture) to 1.81 capillaries per visual field (P < 0.005). A poor microsurgical anastomosis may result in a significant reduction of peripheral tissue perfusion, although blood flow through the main feeding vessel is maintained.
Department of Plastic Surgery, Hand Surgery, Burn Care Unit, University Hospital, Lübeck, Germany. snownessi@web.de
Björn D
BD
Krapohl
Bert
B
Reichert
Hans-Günther
HG
Machens
Peter
P
Mailänder
D000714:Anastomosis, Surgical / Q000009:adverse effects*; D000818:Animals; D004195:Disease Models, Animal; D007083:Iliac Artery / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008866:Microsurgery / Q000009:adverse effects*; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery*; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000503:physiopathology*; D011183:Postoperative Complications; D051381:Rats; D017207:Rats, Sprague-Dawley; D013536:Suture Techniques / Q000009:adverse effects*; D013997:Time Factors; D014654:Vascular Patency / Q000502:physiology