Impact of poor microsurgical suture technique on tissue perfusion in a rat model

Abstract

This study was designed to evaluate the effect of poor suture technique in microsurgical small-vessel anastomosis on tissue microcirculation. Eighteen male Sprague-Dawley rats were divided into three groups of six animals each: sham control group, regular suture group (control), and inverting suture group. In the regular suture group, a standard single-stitch suture technique was used for microsurgical reanastomosis of the transected common iliac artery. In the inverting suture group, a suture technique was applied inverting the vessel wall, thus simulating poor suture technique. After 24 h, intravital microcirculatory measurements were obtained in the cremaster muscle flap. The inverting suture caused a significant drop in capillary perfusion from 6.40 (sham control) and 5.65 (regular suture) to 1.81 capillaries per visual field (P < 0.005). A poor microsurgical anastomosis may result in a significant reduction of peripheral tissue perfusion, although blood flow through the main feeding vessel is maintained.

Validation of microsurgical models in microsurgery training and competence: A review

“…Rat models are probably effective tools to explore investigative research questions, such as basic mechanism of flap survival and further surgical design and remain of significant value in research. 42,48,49 The epigastric flap, with a constant anatomy in the rat, showed to be an acceptable reproducible laboratory model to practice microsurgery steps of flap harvesting on the superficial epigastric vessles, flap anastomosis on femoral vessels, pedicle dissection, and microvascular anastomoses. 40 The cervical area of the rat facilitates advanced training in microsurgical techniques.…”

Blood flow analyses by intraoperative transit‐time flow measurements of free flaps for head and neck reconstructions: A prospective single‐center study

“…Free flap transfer is the gold standard for complex hard and soft tissue reconstruction in the head and neck area. Event‐free healing and stable reconstruction is based on sufficient vascular supply, enabled by technically flawless microvascular anastomoses of one artery and at least one comitant vein (Khaja et al, 2017; Krapohl et al, 2003). Overall free flap survival in the head and neck area ranges between 93% and 97%, maintained by ongoing developments in materials and refinements in surgical techniques (Bui et al, 2007; Mücke et al, 2016).…”