Pruthi Nupur, Gohil Dhaval, Somanna Sampath
National Institute of Mental Health and Neurosciences (NIMHANS), Department of Neurosurgery, Bangalore, Karnataka, India.
Turk Neurosurg. 2019;29(4):615-619. doi: 10.5137/1019-5149.JTN.22646-18.3.
In side to side anastomosis and end to end (one way up) microvascular anastomosis, the back wall of the vessel is sutured first with inverted/buried knots. A common mistake made by surgeons during this step is the formation of a granny knot. In inverted suturing, cut ends of granny knot points inside the vessel lumen and interfere with the suture line. This additional Intraluminal thread may promote foreign body reaction and may act as a nidus for thrombus formation. Hence, this subtle mistake in knot formation may cause immediate and/or delayed anastomosis failure. The purpose of the study was to describe principles of inverted/buried reef knot formation. We describe in detail the methodology to form an inverted reef knot in microsurgery using paracords and a glove model.
在端侧吻合和端端（一端向上）微血管吻合中，血管后壁首先用倒缝/埋结法缝合。外科医生在这一步骤中常犯的一个错误是形成方结。在倒缝时，方结的末端指向血管腔内，会干扰缝合线。这条额外的腔内线可能会引发异物反应，并可能成为血栓形成的病灶。因此，这种打结时的细微错误可能会导致立即和/或延迟的吻合失败。本研究的目的是描述倒缝/埋入式平结形成的原则。我们详细描述了在显微手术中使用辅助绳和手套模型形成倒缝平结的方法。
