The effects of tension on microvascular anastomoses
Tóm tắt
A study was undertaken to determine the effect of tension on microvascular arterial and venous repairs. A standard length of rabbit femoral artery and vein was repaired under tension following excision of a central segment. As larger segments were removed repairs came under increasing tension. Anastomoses under mild or moderate tension which were patent immediately following repair remained open and were not affected by tension. Severe tension occurring after removal of 12 to 14 mm segments in arteries and 6 to 8 mm segments in veins resulted in greater tearing of the endothelium and internal elastic lamina, narrowing, ridging between sutures, and collapse of the vessel wall. Considering the length of the vessel segment mobilized, micro-arteries in the rabbit can be stretched over twice the distance of veins and still remain patent. Lumen narrowing and convolution, coupled with exposure of thrombogenic surfaces beneath the internal elastic lamina at tear holes around sutures, and in areas proximal and distal to the repair site in vessels repaired under tension, are the key factors in the formation of thrombus and anastomotic failure.
Tài liệu tham khảo
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