title: Stabilization of microvascular pedicles in intricate locations using fibrin glue.
abstract: In reconstructive microsurgery, it is occasionally advantageous to use long recipient or donor vessels for optimal flap inset. These long vessels are prone to kinking or torsion along their longitudinal axis from vessel distension during blood inflow and rising blood pressure. More often than arteries, the veins can also be compressed by overlying tissue sutured under tension or by developing edema. Reanastomosis can no longer be feasible or desirable for several reasons, and the elongated vessels may have to be shifted to a curved course. To avoid detrimental kinking or torsion, fibrin glue can be administered along this new vessel course in order to ensure stabilization. In 20 such cases, we successfully avoided complications when the danger of kinking, torsion, or vein compression was evident after successful anastomosis. On the basis of this experience, we recommend the use of fibrin glue in microsurgical procedures, especially for vessels in intricate geometrical locations.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Innsbruck Medical University, Innsbruck, Austria. anton.schwabegger@i-med.ac.at
authors.forename: Anton H
authors.initials: AH
authors.lastname: Schwabegger
authors.forename: Timm O
authors.initials: TO
authors.lastname: Engelhardt
authors.forename: Johannes
authors.initials: J
authors.lastname: Jeschke
mesh_terms: D000328:Adult; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*; D014014:Tissue Adhesives / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives