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[用于显微外科手术的静脉移植的最佳供区]

[An optimum donor site for venous grafting for microsurgery].

作者信息

Grimaud O, Delpit X, Hardy P

机构信息

Service de chirurgie orthopédique et de traumatologie, CHU Ambroise-Paré, Boulogne-Billancourt, France.

出版信息

Chir Main. 2011 Jun;30(3):205-10. doi: 10.1016/j.main.2011.04.008. Epub 2011 May 10.

Abstract

We report the results of an anatomic study based on 10 cadavers. The aim of this work is to find an optimum donor site for venous grafts which is safe, reproducible, and suitable for microsurgery stitches especially in finger reimplantation, when a long and small calibre graft is needed. This study describes the deep venous network of the radial artery, an original donor site for microsurgical venous grafts. The second aim is to describe our technique of harvesting. Dissections always show two satellite veins, that can be harvested with optimal average diameter of 1.8mm constant over the whole length. The maximum length available is about 126.5mm for the radial satellite vein, and 125 mm for the ulnar one, with a few number of collateral ligatures needed. No tying is required in 60% cases for radial satellite vein, and one ligature for the other 40%, whereas in the ulnar satellite vein, no tying is needed in 80% and just one in the other 20%. This original site is advantageous in microsurgery of the upper limb, offering an easy, quick, safe and reproducible option in an emergency situation.

摘要

我们报告了一项基于10具尸体的解剖学研究结果。这项工作的目的是找到一个静脉移植物的最佳供体部位,该部位安全、可重复,并且适合显微外科缝合,特别是在手指再植需要长而小口径移植物时。本研究描述了桡动脉的深静脉网络,这是一个显微外科静脉移植物的原始供体部位。第二个目的是描述我们的采集技术。解剖总是显示出两条伴行静脉,其平均直径为1.8mm,在整个长度上恒定且可最佳采集。桡侧伴行静脉的最大可用长度约为126.5mm,尺侧伴行静脉为125mm,需要的侧支结扎数量较少。桡侧伴行静脉60%的病例无需结扎,其余40%只需一个结扎;而尺侧伴行静脉80%无需结扎,另外20%只需一个结扎。这个原始部位在上肢显微外科手术中具有优势,在紧急情况下提供了一个简单、快速、安全且可重复的选择。

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