Irrigation pressure and vessel injury during microsurgery: a qualitative study.
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.
Yan
Ji-Geng
JG
Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee 53226, USA.
Yousif
N John
NJ
Dzwierzynski
William W
WW
Matloub
Hani S
HS
Sanger
James R
JR
Shehadi
Imad E
IE
Siegesmund
Kenneth A
KA
D000818:Animals; D004730:Endothelium, Vascular / Q000293:injuries* / Q000473:pathology; D008866:Microsurgery; D011312:Pressure; D011817:Rabbits; D007507:Therapeutic Irrigation / Q000009:adverse effects