MD, Resident. Department of Plastic Surgery - Hospital das Clínicas - Faculdade de Medicina de Botucatu - Botucatu (SP), Brazil.
PhD, Full Professor. Department of Plastic Surgery - Hospital das Clínicas - Faculdade de Medicina de Botucatu - Botucatu (SP), Brazil.
Acta Cir Bras. 2021 Oct 8;36(8):e360807. doi: 10.1590/ACB360807. eCollection 2021.
To evaluate the impact of submersion of the microsurgical anastomosis suture area using saline (0.9% NaCl) in an experimental laboratory during the training of medical students and resident physicians.
Wistar rats (n = 10) were selected to have the two femoral arteries sectioned and anastomosed end-to-end under optical magnification. They were randomly divided, so that on one side suturing was performed under submersion with saline, and the contralateral side was kept dry during the procedure. The surgical times, as well as the patency within 30 min and 72 h of the procedure, were evaluated.
Six male Wistar rats survived the surgical anesthetic procedure, with the average initial weight of 243.3 g and the average artery diameter of 0.86 mm, with average time of 15.67 min for the submerged technique and 20.50 min for the dry technique (p = 0.03). The failure rates were 17 and 50% for the submerged group and the dry one, respectively (p = 0.62).
Submerged microvascular suture does not compromise the patency of the vessel or increase the time of anastomosis. Therefore, it is a strategy that can be applied by the surgeon according to his/her technical preferences.
评估在医学生和住院医师培训过程中,使用生理盐水(0.9% NaCl)对显微吻合缝线区域进行浸没的影响。
选择 Wistar 大鼠(n = 10),将其两条股动脉切断并在光学放大下端端吻合。随机分组,一侧缝线在盐水浸没下进行,另一侧在手术过程中保持干燥。评估手术时间,以及术后 30 分钟和 72 小时的通畅率。
6 只雄性 Wistar 大鼠在手术麻醉过程中存活,平均初始体重为 243.3 g,平均动脉直径为 0.86 mm,水下技术的平均时间为 15.67 分钟,干燥技术的平均时间为 20.50 分钟(p = 0.03)。水下组和干燥组的失败率分别为 17%和 50%(p = 0.62)。
水下显微缝线不会影响血管通畅,也不会增加吻合时间。因此,这是一种根据外科医生的技术偏好可以应用的策略。