J Reconstr Microsurg 2009; 25(3): 197-202
DOI: 10.1055/s-0028-1103509
© Thieme Medical Publishers

Interpositional Vein Graft Suturing over Temporary Silastic Tube

Ozan Bitik1 , Erhan Sönmez1 , Tunc Safak1 , Abdullah Kecik1
  • 1Department of Plastic and reconstructive surgery, Hacettepe University Faculty of Medicine, Sihhiye/Ankara/Turkey
Further Information

Publication History

Publication Date:
01 December 2008 (online)

ABSTRACT

Interpositional vein grafting is the gold standard for the replacement of vascular defects. Although many microsurgeons have used classical suture anastomosis successfully, it is still technically challenging, especially for the inexperienced surgeon. We present a new technique that facilitates autogenous vein grafting by using a commercially available silastic tube employed temporarily during the suture anastomosis and removed at the end of the procedure. Effects of this technique on operative time and patency were tested by an experienced and an inexperienced microsurgeon. Each surgeon operated on a total of 20 rats divided in experimental and control groups of 10 animals each. The experimental group was operated on with silastic-tube-assisted suture anastomosis, and the control group was operated on using the classical suture anastomosis without using the device. For the experienced microsurgeon, proposed modification resulted in a statistically significant reduction in operative time without an effect on patency. For the inexperienced microsurgeon, the proposed modification resulted in a statistically significant reduction in operative time and also enhanced patency rates significantly. Interpositional vein grafting over a temporary silastic tube is a practical modification of the classical microvascular anastomosis that adds speed and ease to the microvascular vein grafting procedure and prevents back-wall biting, particularly for inexperienced microsurgeons.

REFERENCES

  • 1 Miller M, Schusterman M, Reece G et al.. Interposition vein grafting in reconstructive head and neck microsurgery.  J Reconst Microsurg. 1993;  9 245-251
  • 2 Akyürek M, Safak T, Keçik A. Ring avulsion replantation by extended debridement of the avulsed digital artery and interposition with long venous grafts.  Ann Plast Surg. 2002;  48 574-581
  • 3 Joji S, Muneshige H, Ikuta Y. Experimental study of mechanical microvascular anastomosis with new biodegradable ring device.  Br J Plast Surg. 1999;  52 559-564
  • 4 Kim B Y, Choi B H, Huh J Y et al.. Microvascular anastomosis using cyanoacrylate adhesives.  J Reconstr Microsurg. 2004;  20 317-321
  • 5 Hallock G G. Intimal staining for visibility enhancement during microanastomoses.  Ann Plast Surg. 1991;  26 122-124
  • 6 Ozkan O, Ozgentas E. Open guide suture technique for safe microvascular anastomosis.  Ann Plast Surg. 2005;  55 289-291
  • 7 Acland R D. Microvascular anastomosis: a device for holding stay sutures and a new vascular clamp.  Surgery. 1974;  75 185-187
  • 8 Crowell R M, Yasargil M G. Experimental microvascular autografting. Technical note.  J Neurosurg. 1969;  31 101-104
  • 9 Ganske J G, Demuth R J, Miller S H et al.. Comparison of expanded PTFE microvascular grafts to autogenous vein grafts.  Plast Reconstr Surg. 1982;  70 193-201
  • 10 Gilbert R W, Ragnarsson R, Berggren A et al.. Microvenous grafts to arterial defects. The use of mechanical or suture anastomoses.  Arch Otolaryngol Head Neck Surg. 1989;  115 970-976
  • 11 Reinert S, Horn H, Burrig K F. Microvascular anastomosis of interpositional vein grafts with sutures and a new mechanical device: a histologic and scanning electron microscopic study.  Int J Oral Maxillofac Surg. 1994;  23 434-436
  • 12 Qu W, Muneshige H, Ikuta Y. An absorbable pinned-ring device for microvascular anastomosis of vein grafts: experimental studies.  Microsurgery. 1999;  19 128-134
  • 13 Parmaksızoglu F, Beyzadeoglu T. A modified method of microvascular autogenous interposition vein grafting for vascular reconstruction.  J Reconstr Microsurg. 2002;  18 191-194
  • 14 Whitaker I S, Izadi D, Allen F. A novel technique to aid vein graft preparation in the microsurgery laboratory.  Ann Plast Surg. 2007;  58 232-233

Erhan SönmezM.D. 

Plastic surgery resident, Hacettepe Üniversitesi Hastanesi

Plastik ve Rekonstrüktif Cerrahi Anabilim Dalı, 06100, Sihhiye/Ankara/Turkey

Email: erhans@hacettepe.edu.tr

    >