Comparison of the Microvascular Anastomosis Maturation in Continuous and Interrupted Suture Technique.

Abstract

BACKGROUND Use of interrupted sutures in microvascular anastomosis is widely accepted standard technique. Usage of continuous running suture (CRS) is less common due to the presumption that its mechanical firmness can negatively affect anastomosis maturation, but shorter surgical time can be an important factor in the prevention of tissue ischemia. Purpose of this study was to determine whether the use of CRS allows microvascular anastomosis maturation. MATERIAL AND METHODS A rat common carotid artery (CCA) end-to-end microanastomosis model was used, with 19 Long-Evans rats in the interrupted suture group and 13 Long-Evans rats in the CRS group. An immediate blood flow of the operated and the contralateral intact CCA was compared to each other at the time of the anastomosis completion and after 14 days. Quantitative transit time flowmetry measurement and histological examination were used. RESULTS Initial blood flow in both intact CCAs was equal in all animals (p =.004). In the interrupted suture group, the median anastomosis blood flow was 88.9% of the contralateral CCA, median time needed for the suture was 46 minutes. The blood flow after two weeks increased to 96.1%. In the CRS group, the median anastomosis blood flow was 88.3% of the contralateral CCA, median time needed for the suture was 30 minutes. The blood flow after two weeks increased to 100.0%. Achieved suture time reduction was 34.8% (p <.001). Histological examination showed a mature scar. CONCLUSIONS In our study, CRS and interrupted suture microanastomosis maturation rate was comparable. Use of CRS allowed a significant surgical time reduction.