Division of Plastic Surgery, Sacred Heart Hospital and the Lehigh Valley Hospitals, Allentown, Pennsylvania, USA.
J Reconstr Microsurg. 2010 Sep;26(7):471-4. doi: 10.1055/s-0030-1254231. Epub 2010 May 12.
The use of ring-pin devices as a nonsuture alternative for microanastomoses is expedient and highly practical, with excellent patency rates. A frequently encountered problem, though, is a significant discrepancy between the donor and recipient vessel lumen size. Rather than accepting the choice of a smaller ring size corresponding to the caliber of the smaller vessel, it may be preferable to instead increase the latter's circumference for potential eversion on the pins by either beveling or "fish-mouthing" the end of the vessel. Arithmetical calculations suggest that a 25% increase in dimensions can thereby be possible at least for thin-walled venous structures. Not only does the capability for selection of a size larger ring simplify drawing the vessel wall through the ring orifice prior to pin impalement, but the resulting larger anastomotic lumen should theoretically increase the potential flow rate across the microanastomosis.
使用环钉装置替代缝线进行微吻合是一种方便且实用的方法，具有出色的通畅率。然而，一个经常遇到的问题是供体和受体血管腔大小之间存在显著差异。与其选择与较小血管口径相对应的较小环尺寸，不如通过斜面或“鱼嘴”处理血管末端来增加后者的周长，以便在环钉上进行潜在外翻。算术计算表明，对于薄壁静脉结构，至少可以增加 25%的尺寸。不仅选择较大环的能力简化了在刺穿环钉之前将血管壁拉入环孔的过程，而且理论上较大的吻合腔直径应该会增加微吻合术的潜在血流速度。
