Su W F, Chen L E, Seaber A V, Urbaniak J R
Orthopaedic Research Laboratories, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Int Angiol. 1995 Sep;14(3):243-7.
Replantation after crushing amputation has a relatively low success rate. Although the mechanism of trauma is a major factor in failure, the time lapse before vessel anastomosis may also be a contributing factor. In this study, we observed the influence of the interval between vessel injury and surgical treatment on thrombus formation and healing after controlled crushing. Seventy-five Sprague-Dawley rats were used. A segment of femoral artery was clamped to create warm ischemia for 8 hours and crushed with a 15 kg load for one hour. After the loading device was removed the crushed segments were transected and the vessel ends exposed to the adjacent tissues and blood for 0, 2, 4 and 6 hours (groups II-V, respectively) prior to being anastomosed with standard microsurgical technique. The vessel samples were harvested at days 1, 2 and 7, respectively, and evaluated by light microscopy and scanning electron microscopy (SEM). The patency rate of the anastomoses was 97.3% at harvest and reendothelialization was completed at day 7. Three anastomoses with 4 or 6 hours exposure showed thrombosis, or clotting. The results indicated that up to 6 hours exposure time did not have a significant influence on thrombus formation or the healing process of vessels under the controlled conditions of this study.
挤压离断再植术后成功率相对较低。尽管创伤机制是手术失败的主要因素，但血管吻合前的时间间隔也可能是一个影响因素。在本研究中，我们观察了在可控挤压伤后血管损伤与手术治疗之间的时间间隔对血栓形成及愈合的影响。选用75只Sprague-Dawley大鼠。夹闭一段股动脉造成8小时热缺血，并用15千克重物挤压1小时。移除加载装置后，将挤压段切断，在采用标准显微外科技术吻合血管之前，使血管断端暴露于邻近组织和血液中0、2、4和6小时（分别为II-V组）。分别在第1、2和7天采集血管样本，通过光学显微镜和扫描电子显微镜（SEM）进行评估。取材时吻合口通畅率为97.3%，内皮化在第7天完成。3个暴露4或6小时的吻合口出现血栓形成或凝血。结果表明，在本研究的可控条件下，长达6小时的暴露时间对血栓形成或血管愈合过程没有显著影响。
