Chaturvedi Gaurav, Singh Abhinav, Prakash Rao Cheruvu Ved, Gupta Ashish Kumar, Khan Manal Mohd, Suhag Kanika
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India.
Department of Burns, Plastic & Reconstructive Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
J Hand Microsurg. 2025 Jan 24;17(2):100216. doi: 10.1016/j.jham.2025.100216. eCollection 2025 Mar.
The study aimed to evaluate the effectiveness of the interrupted horizontal micro mattress suturing technique in anastomosing size-mismatched vessels during free flap surgeries.
MATERIAL & METHOD: The study included patients who underwent free flap surgery and encountered size disparities in vessels intraoperatively. The technique was applied to 24 patients with 28 mismatched blood vessels. Interrupted horizontal micro-mattress sutures were utilized to adjust the diameter mismatch between incongruent vessels. Each suture aimed to reduce the diameter of the larger vessel in comparison to the smaller vessel.
During free flap surgeries, the technique was successfully applied across various body regions, from head to toe. Out of the 28 vessels where anastomosis was performed using this technique, two patients experienced thrombosis. This technique enabled anastomosis of vessels with a size mismatched ratio up to 2:1.
The interrupted micro mattress suturing technique proves to be a straightforward, secure, and dependable for addressing vessel size discrepancy up to 2:1. An additional benefit of this technique is its ability to circumvent the need for end-to-side repair, enhancing its utility in eversion of margins of repaired blood vessels and practicality in free flap surgeries.
本研究旨在评估间断水平褥式缝合法在游离皮瓣手术中吻合管径不匹配血管的有效性。
本研究纳入了接受游离皮瓣手术且术中遇到血管管径差异的患者。该技术应用于24例患者的28条不匹配血管。采用间断水平褥式缝合来调整不相容血管之间的管径差异。每针缝合旨在使较大血管的管径相对于较小血管缩小。
在游离皮瓣手术中，该技术成功应用于从头部到脚趾的各个身体部位。在使用该技术进行吻合的28条血管中，有2例患者发生血栓形成。该技术能够吻合管径不匹配比例高达2:1的血管。
间断褥式缝合法被证明是一种简单、安全且可靠的方法，可解决高达2:1的血管管径差异问题。该技术的另一个优点是无需进行端侧修复，提高了修复血管边缘外翻的实用性以及在游离皮瓣手术中的实用性。
