摘要:

AbstractThe finger‐tip replantation technique reported here has evolved over 15 years. Indications for surgery include both strong patient desire and specialized use of the finger tip. Palmar flaps are elevated as full‐thickness skin grafts to avoid injury to palmar veins. Arteries and palmar digital veins are repaired using an open‐vessel technique. Postoperative care varies from immediate discharge with follow‐up to inpatient care using surgical leeches or continuous bleeding as a method of drainage should venous congestion develop. The survival rate of 26 finger tips replanted using this technique between 1981 and 1987 was 69%. Two‐point discrimination returned in 75% of patients, and 25% had two‐point discrimination of less than 5 mm. The distal interphalangeal joint retained an average range of motion of 56°. Appearance was excellent, and patient satisfact

ISSN:0738-1085    

DOI:10.1002/micr.1920100102

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractA case is presented of a nose bitten off by a dog and successfully replanted by artery‐to‐artery and artery‐to‐vein anastomosis. In the absence of vein‐to‐vein anastomosis, the clinical course suggested that artery‐to‐vein anastomosis was useful for venous drainage, although the extent to which this contributed to the surviv

ISSN:0738-1085    

DOI:10.1002/micr.1920100103

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThe present study examined the effect of phosphoenolpyruvate (PEP) and adenosine triphosphate (ATP) on rabbit skeletal muscle flap survival after warm ischaemia.Two muscle flap models, rectus femoris pedicle flap and latissimus dorsi free flap, were subjected to a total ischaemia of 4 hours at 37°C and 20°C, respectively. Immediately prior to revascularisation, the muscles were infused with either Hanks' balanced salt solution (BSS) or Hanks' BSS containing 200 μmol PEP and 6.6 μmol ATP. Quantification of muscle damage was determined by measuring the plasma levels of creatinine kinase (CK), lactate dehydrogenase (LDH), lactate, potassium, and phosphate at 0, 2, 24, and 96 hours after revascularisation. Infusion of PEP/ATP compared with Hanks' BSS alone significantly decreased the efflux of CK in both rectus femoris (P<0.025) and latissimus dorsi muscles (P<0.05) and of LDH in the rectus femoris muscle (P<0.01). No significant changes were observed, however, for the plasma levels of lactate, potassium, and phosphate. From this study it was concluded that PEP and ATP partially protect skeletal muscle from ischaemia and reperfusion inj

ISSN:0738-1085    

DOI:10.1002/micr.1920100104

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThis study demonstrates the use of the tissue perfusion monitor in the investigation of arterialization (using an arteriovenous fistula) of the heterotopic partial liver transplant. An index of peak perfusion rate was introduced as a reliable and accurate measure of the index of delivery rate of blood to the liver. Results revealed a significant (P<.01) difference between arterialized and nonarterialized liver grafts when compared with their respective recipient host livers. Arterialization of grafted livers raised the index of peak perfusion rate to levels that were comparable to host livers. Arterialization also had a significant effect (P<.01) on the host liver, whose values dropped by 74.26% when compared with the normal liver. Surprisingly, host values of the nonarterialized group fell by 61.54%. At this point, explanations for this phenomenon are speculatory. An extensive review of the literature exposes the variability in the observations of the role and usefulness of arterialization in hepatocellular function.

ISSN:0738-1085    

DOI:10.1002/micr.1920100105

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThis study quantitatively assesses the hemodynamic consequences of inserting a 1.5‐mm polyethylene anastomotic device in both small arteries and veins. The device was placed in 20 rabbit femoral arteries and 20 femoral veins. Using 20‐MHz pulsed ultrasonic Doppler velocimetry techniques, blood flow was measured in 5 immediate postoperative intervals and at the 24‐hour and 3‐week postoperative intervals. In arteries, volumetric flow (Q) was not statistically different in any postoperative interval; maximum spatial velocity (Vmax) was significantly increased in the immediate postoperative intervals but was not different at 24 hours or 3 weeks. In veins, significant decreases in Q and increases in Vmax occurred in the immediate postoperative intervals, but differences were not noted at the 24‐hour or 3‐week intervals. The results of this study indicate that the hemodynamic consequences of anastomosing small vessels with a polyethylene device are minimal and that this mechanical technique is an effective method for experimental microvascu

ISSN:0738-1085    

DOI:10.1002/micr.1920100106

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThis study analyzes the histology associated with the polyethylene ring‐pin device. The device was placed in 20 rabbit femoral arteries and 20 femoral veins. Specimens were harvested at 24‐hour and 3‐week postoperative intervals and were analyzed using light, scanning electron, and transmission electron microscopy. Generally, the reparative process in the arteries and veins was similar. In 24‐hour artery and vein specimens, the endothelial cells were absent, the media tapered within the device, but smooth muscle cells (SMC) remained partially viable. In 3‐week specimens, the device junction was well healed and reendothelialized. Subintimal hyperplasia was present, the internal elastic lamina was not reconstituted, and the SMCs were partially viable. Small vascular channels formed at the device junction, and small venous valves were noted near the device. Macrophages lined the margins of the device. The early reparative process proceeds favorably, by histologic criteria, after vessel repair with the polyethylene ring

ISSN:0738-1085    

DOI:10.1002/micr.1920100107

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractThe Unilink system, a mechanical anastomotic device, was compared with standard suture techniques in terms of anastomotic strength under conditions of uniaxial loading. Twenty‐five rabbits underwent Unilink and suture anastomosis of both carotid arteries and facial veins. Animals were sacrificed at 1 hour (five animals), 2 weeks (10 animals), and 16 weeks (10 animals), and all vessels were tested by constant loading in a material testing machine. The maximum load required to disrupt the anastomosis as well as the site of vessel failure were recorded.All 100 anastomoses were fully patent as evaluated by clinical testing. At 1 hour and 2 weeks, the Unilink arterial anastomoses were consistently and significantly stronger than the sutured anastomoses. At 16 weeks the sutured arterial anastomoses were significantly stronger than Unilink. The Unilink anastomoses, however, remained approximately 50% stronger than unoperated normal vessels. No statistical differences were observed in the strength of venous anastomoses at any of the intervals tested. There were no statistical differences in the sites of failure of the vessels under loading (i.e., at the anastomosis or proximal or distal to it) between the two technique

ISSN:0738-1085    

DOI:10.1002/micr.1920100108

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractExpanded polytetrafluoroethylene (PTFE) prostheses with fibril lengths of 30 and 60 μm were implanted in the rat infrarenal aorta. Sequential scanning electron and light microscopic studies of the prostheses after implantation demonstrated a different pattern of endothelialization. Prostheses with a fibril length of 60 μm had a continuous multilayered neointima at week 25 postimplantation, whereas prostheses with a 30‐μm fibril length had a discontinuous and single layer of endothelium after the same interval. It was concluded, therefore, that a prerequisite for the development of a lining in a vascular prosthesis is for the inner surface of the prosthesis to have adequate pores for effective anchoring of the invading endothelioid cells. Expanded PTFE prostheses with an internodular distance of 60 μm provided sufficient anchoring possibilities for invading endothelioid cells to form a continuous neoi

ISSN:0738-1085    

DOI:10.1002/micr.1920100109

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractA study was designed to test various high‐molecular‐weight solutions in the prevention of postoperative intraabdominal adhesions. The bicornuate rat uterus was used as the surgical model, and 80 mature white female rats underwent surgical injury of the right uterine horn. The rats were randomly divided into 5 groups: groups A, B, and C received 5 ml intraperitoneally of chondroitin sulfate, sodium carboxymethylcellulose, and 32% dextran 70, respectively; group D was treated with microsurgical repair; and group E, the control, received no therapy. The animals were killed postoperatively, and the adhesions were scored. Significantly better results in adhesion prevention were demonstrated in the sodium carboxymethylcellulose group vs. the other groups, except in group A where the difference was not signific

ISSN:0738-1085    

DOI:10.1002/micr.1920100110

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY

摘要:

AbstractWe believe that the randomness of sprout regrowth is the cause of most poor experimental and clinical functional results after nerve repair. We have elaborated a technique of repair, called “nerve reconnection” aiming to minimize randomness of regrowth. This technique enhances the precision of repair by minimizing physical and chemical damage to the stumps and by ensuring stress‐free stump abutment. In this study, the reconnection technique was compared to the conventional microsuture method. First, both techniques were tested as the primary method of repair. A method of behavioral evaluation, the sciatic functional index, was used to assess the results. The reconnection groups consistently showed satisfactory functional results, even after two successive procedures. In contrast, only one‐third of the animals in the suture groups reached satisfactory functional levels. In the second part of the study, animals with unsatisfactory results after primary suture were reoperated in an attempt to improve the poor results of initial surgery. The secondary procedures used were either the reconnection technique or conventional microsuture. All secondary procedures failed to improve poor preexisting functional conditions. These findings stress the importance of the original “blueprint” of the nerve and the necessity of maintaining this unique pattern during ini

ISSN:0738-1085    

DOI:10.1002/micr.1920100111

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1989

数据来源: WILEY