Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Asian J Surg. 2019 Jan;42(1):409-413. doi: 10.1016/j.asjsur.2018.05.005. Epub 2018 Aug 7.
Though microvascular clamps are widely used for anastomosis training, there still have several shortcomings, including the bulging, expensiveness and unavailability due to sterilization. The aim of this study is to introduce a simple and novel microvascular training model without use of microvascular clamps.
Femoral vessels of Sprague Dawley rats training model were used to evaluate the usefulness of 4-0 silk as a slipknot for performing arterio-arterial and veno-venous microvascular anastomoses. A total of 12 Sprague Dawley rats were randomly assigned to either slipknot group or vascular clamp group. We also assess other endpoints, including ischemic time, patency rate, and clinical features. An additional histological study was performed to compare their immediate traumatic effects on vessel wall.
There was no ischemic change or congestive sign in the lower limb after microvascular anastomosis. The total warm ischemic time for the vascular anastomosis was not significantly different. We performed the patency test immediately after microvascular anastomosis and one week after surgery. No intraoperative vascular bleeding was found during these procedures and no thrombosis occurred postoperatively. The histologic damages to occluded area were not significantly different in both groups.
We demonstrate a microsurgical suture technique performed without any vascular clamp on a rat model. This rat model was designed for training in the technique of microvascular anastomosis. Compared with microvascular clamps, silk slipknot is a cheap, easily available, less space-occupying technique while performing microvascular anastomoses training. This preliminary study provides a simple and effective alternative method for microvascular anastomosis training.
尽管微血管夹被广泛用于吻合训练,但仍存在一些缺点,包括因消毒而凸起、昂贵和不可用。本研究旨在介绍一种无需使用微血管夹的简单新颖的微血管训练模型。
使用 Sprague Dawley 大鼠训练模型的股血管来评估 4-0 丝线作为滑结在进行动脉-动脉和静脉-静脉微血管吻合中的有用性。总共 12 只 Sprague Dawley 大鼠被随机分配到滑结组或血管夹组。我们还评估了其他终点,包括缺血时间、通畅率和临床特征。还进行了组织学研究以比较它们对血管壁的即时创伤影响。
微血管吻合后下肢无缺血改变或充血征象。血管吻合的总热缺血时间无显著差异。我们在微血管吻合后立即和手术后一周进行通畅性测试。这些过程中没有发现术中血管出血,也没有术后血栓形成。两组闭塞区域的组织学损伤无明显差异。
我们在大鼠模型上演示了一种无需任何血管夹的显微缝合技术。该大鼠模型旨在用于微血管吻合技术的训练。与微血管夹相比,丝线滑结是一种廉价、易于获得、占用空间小的技术,同时进行微血管吻合训练。这项初步研究为微血管吻合训练提供了一种简单有效的替代方法。