Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Debrecen, Hungary; Doctoral School of Clinical Medicine, University of Debrecen, Debrecen, Hungary.
Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Injury. 2020 Dec;51(12):2866-2873. doi: 10.1016/j.injury.2020.02.104. Epub 2020 Feb 21.
The biomechanical properties of small vessels and microvascular anastomoses have not been studied completely yet. However, in case of vascular injury and various microsurgical reconstructive procedures a safe anastomosis is essential. Quick and reliable tests are needed to test various anastomoses in research and in teaching courses as well for quality control and proper feedback. We aimed to compare selected biomechanical properties of the simple interrupted, the continuous suture and the modified Lauritzen's sleeve-technique.
Sixty femoral arteries from chicken thigh biopreparates and 12 abdominal aortas from rats were used in this study. In case of the pressure resistance test the groups were: the simple interrupted, the continuous suture and the modified Lauritzen's sleeve-technique. The tensile-strength, elongation and elasticity measurement groups were the simple interrupted and continuous sutures with 8 and 12 stitches. Furthermore the suture materials in various conditions (simple thread, knotted threads, stitch with intact and damaged threads) were also compared. The tensile-strength and the pressure probe devices were custom made in cooperation with the Faculty of Informatics.
The average diameter of the chicken femoral arteries was 3.25±0.38 mm. The sleeve-technique showed the biggest pressure drop (56±16.41 mmHg), however, it was the fastest method. The tensile-strength of simple interrupted suture was 4.55±0.7 Newton (N), being lower than of the intact vessel (6.8 ± 1.4 N). The tensile-strength did not differ significantly between the 12-stitch simple interrupted and continuous sutures, however, the latter was stronger. The anastomoses made on thread model were significantly stronger than the ones on vessels.
The main variables were the number of stitches and the strength of the vessel. The pressure drop was not correlated with the stitch number. One incorrect stitch can dramatically increase the leakage. Although the sleeve-technique is quick to be performed, it cannot withstand high pressure. The suture material itself is far stronger then the vessel. The vessel tensile strength was decreased in the anastomoses. For the given vessel diameter more than 8 stitches should be used.
小血管和微血管吻合的生物力学特性尚未得到完全研究。然而，在血管损伤和各种显微重建手术中，安全的吻合是必不可少的。需要快速可靠的测试来测试各种吻合，无论是在研究中还是在教学课程中，都需要进行质量控制和适当的反馈。我们旨在比较简单间断缝合、连续缝合和改良Lauritzen 套管技术的选定生物力学特性。
本研究使用了 60 只鸡大腿生物标本的股动脉和 12 只大鼠的腹主动脉。在耐压力测试中，实验组分别为：简单间断缝合、连续缝合和改良 Lauritzen 套管技术。在拉伸强度、伸长率和弹性测量组中，实验组分别为 8 针和 12 针的简单间断缝合和连续缝合。此外，还比较了不同条件下的缝线材料（普通缝线、打结缝线、缝线有完整缝线和损坏缝线）。拉伸强度和压力探针装置是与信息学院合作定制的。
鸡股动脉的平均直径为 3.25±0.38 毫米。套管技术的压降最大（56±16.41 毫米汞柱），但它是最快的方法。简单间断缝合的拉伸强度为 4.55±0.7 牛顿（N），低于完整血管（6.8±1.4 N）。12 针简单间断缝合和连续缝合的拉伸强度没有显著差异，但后者更强。缝线模型上的吻合强度明显高于血管上的吻合强度。
主要变量是缝线的数量和血管的强度。压降与缝线数量无关。一个错误的缝线可以显著增加泄漏。虽然套管技术的操作速度很快，但它无法承受高压。缝线材料本身比血管强得多。吻合处的血管拉伸强度降低。对于给定的血管直径，应该使用超过 8 针缝线。
