Ang E S, Tan K C, Tan L H, Ng R T, Song I C
Department of Plastic Surgery, Singapore General Hospital, Singapore.
J Reconstr Microsurg. 2001 Apr;17(3):193-201. doi: 10.1055/s-2001-14351.
Standard microvascular anastomosis using only sutures is a well-established and successful technique; however, it is time-consuming and may cause vessel narrowing, needle trauma, and tissue reaction. The authors' hypothesis was that 2-octylcyanoacrylate could simplify microvascular anastomosis and reduce wall trauma and reaction. End-to-end anastomoses of the femoral arteries were performed in 20 adult rats. Each animal served as its own control. The time taken for each anastomosis (from first stitch to release of clamps) was noted, and the patency assessed. At day 7, the anastomoses were reassessed for patency, and the vessels evaluated histologically. 2-octylcyanoacrylate reduced the need to insert more sutures. Anastomotic time in the study group was statistically significantly shorter (p < 0.001), and the patency rate was 90 percent, compared to 85 percent with the standard suture technique. There was also less intense inflammatory reaction, with fewer foreign-body granulomata. This is the first report on the use of 2-octylcyanocrylate, currently approved for cutaneous use, for vessel anastomosis. Further work on the biomechanics and long-term histologic effects will be carried out. 2-octylcyanoacrylate has the potential for simplifying and improving the patency rates of arterial microanastomosis.
仅使用缝线进行标准微血管吻合术是一项成熟且成功的技术；然而，它耗时较长，可能导致血管狭窄、针创伤和组织反应。作者的假设是，2-辛基氰基丙烯酸酯可简化微血管吻合术并减少管壁创伤和反应。对20只成年大鼠的股动脉进行端端吻合。每只动物自身作为对照。记录每次吻合所需时间（从第一针到松开血管夹），并评估通畅情况。在第7天，重新评估吻合口的通畅情况，并对血管进行组织学评估。2-辛基氰基丙烯酸酯减少了额外缝线的使用需求。研究组的吻合时间在统计学上显著更短（p < 0.001），通畅率为90%，而标准缝线技术的通畅率为85%。炎症反应也较轻，异物肉芽肿较少。这是关于目前已获批准用于皮肤的2-辛基氰基丙烯酸酯用于血管吻合的首次报告。将进一步开展关于生物力学和长期组织学效应的研究。2-辛基氰基丙烯酸酯具有简化并提高动脉微血管吻合术通畅率的潜力。
