Thomson S R, Gregory M A, Mars M, Natasen J, Naicker T, Baker L W
Department of Surgery, University of Natal Medical School, South Africa.
Br J Plast Surg. 1995 Apr;48(3):165-71. doi: 10.1016/0007-1226(95)90149-3.
The morphological appearance of longitudinally sectioned rat femoral arteries was determined in intact arteries and from 3 to 435 days after vessel division and anastomosis with either 9/0 gauge nylon or polydioxanone (PDS) in 26 animals. The purpose of the study was to establish the mechanisms and compare the quality of healing after microarterial anastomosis and to determine whether PDS was degraded before sufficient anastomotic healing had taken place. The results revealed that there was no difference in the process of healing or quality of anastomosis with either suture material. From 3 to 21 days post anastomosis, there was a progressive separation of the ends of vessels within the developing scar. Anastomotic patency was established and maintained at first by an adventitial overgrowth of fibroblasts and undifferentiated adventitial cells and later by the growth of a smooth myocyte scar that stretched between the cut ends of the vessel and over the intima in the form of elongated circumferential plaques. The vessel was morphologically healed by the 21st day. The sutures served little or no purpose in maintaining anastomotic integrity after the 5th day, being situated in the scar forming between the separating vessel ends. PDS was present within the vessel wall up to 120 days post anastomosis and was certainly intact at the time of morphological healing, suggesting that this material is safe as a microvascular suture.
在26只动物中，对完整大鼠股动脉以及血管切断并分别用9/0号尼龙线或聚二氧六环酮（PDS）吻合后3至435天的纵切股动脉的形态外观进行了测定。本研究的目的是确定微动脉吻合术后的愈合机制并比较愈合质量，以及确定PDS在充分的吻合口愈合发生之前是否已降解。结果显示，使用两种缝合材料时，愈合过程或吻合质量均无差异。吻合术后3至21天，在形成的瘢痕内血管两端逐渐分离。起初，吻合口通畅是通过成纤维细胞和未分化外膜细胞的外膜过度生长来建立和维持的，后来则是通过平滑肌细胞瘢痕的生长来实现的，该瘢痕在血管断端之间延伸，并以细长的环形斑块形式覆盖在内膜上。到第21天时，血管在形态上已愈合。在第5天之后，缝线对维持吻合口完整性几乎没有作用，因为它们位于分离的血管断端之间形成的瘢痕中。PDS在吻合术后120天内一直存在于血管壁内，并且在形态愈合时肯定是完整的，这表明这种材料作为微血管缝线是安全的。
