Chen L E, Seaber A V, Urbaniak J R
Dept. of Surgery, Duke University Medical Center, Durham, North Carolina 27710.
J Reconstr Microsurg. 1993 May;9(3):183-9. doi: 10.1055/s-2007-1006643.
Diametric growth at the anastomotic site, following microvascular anastomoses in pediatric patients, remains a problem, when nonabsorbable suture material is used. This study investigated the long-term effects of femoral artery anastomoses with nonabsorbable sutures in 20 growing rats with a mean weight of 101 g. The right femoral artery was anastomosed with 10-0 polypropylene monofilament suture and the left with identical nylon suture, using 5 to 6 interrupted sutures for each end-to-end anastomosis. At a 6-month harvest, the mean body weight had increased by 729 percent and the diameter of the femoral artery by 240 percent. The patency rate at the anastomotic sites was 97.5 percent and the complication rate was 10 percent, including one occlusion and three aneurysm formations at the sites. Angiography, diameter measurement, and histology demonstrated no stenosis or thrombus formation in all animals. Histology also showed normal vessel lumen size and well-organized re-endothelialization, without intimal hyperplasia at the anastomosis sites. With an interrupted suture technique, nonabsorbable sutures do not compromise growth at the anastomosis site or long-term patency of the anastomosed vessels. This study indicates that interrupted nonabsorbable suture materials are able to create excellent long-term results in microvascular anastomoses in rapidly growing hosts.
在儿科患者进行微血管吻合术后，当使用不可吸收缝合材料时，吻合部位的直径生长仍然是一个问题。本研究调查了20只平均体重为101克的生长中大鼠采用不可吸收缝线进行股动脉吻合的长期效果。使用10-0聚丙烯单丝缝线吻合右侧股动脉，用相同的尼龙缝线吻合左侧股动脉，每端端吻合使用5至6针间断缝合。在6个月时取材，平均体重增加了729%，股动脉直径增加了240%。吻合部位的通畅率为97.5%，并发症发生率为10%，包括该部位1例闭塞和3例动脉瘤形成。血管造影、直径测量和组织学检查显示所有动物均无狭窄或血栓形成。组织学检查还显示血管腔大小正常，内皮再内皮化良好，吻合部位无内膜增生。采用间断缝合技术时，不可吸收缝线不会影响吻合部位的生长或吻合血管的长期通畅。本研究表明，间断不可吸收缝合材料能够在快速生长的宿主的微血管吻合术中产生优异的长期效果。
