PMID: 9556001Apr 29, 1998Paper

The effect of prolonged clamping and vascular stasis on the patency of arterial and venous microanastomoses

Annals of Plastic Surgery
J Grant ThomsonR J Restifo

Abstract

During free tissue transfer, an artery and one or two veins must be sutured. Either the artery or the vein can be repaired first, but the optimal order of vascular repair has not been established. Maintaining a clamp on a vessel is associated with vessel injury, and releasing the clamp may cause bleeding and vascular stasis. The purpose of this study was to determine if the order of vessel repair and the length of vascular clamping affects surgical outcome. Free flaps were created on Sprague-Dawley rats (400-450 g) as follows: Bilateral abdominal skin flaps (3 x 3 cm) based on the superficial inferior epigastric vessels were elevated. The femoral artery and vein were tied and divided distal to the branching of the inferior epigastric vessels. Proximal to the branching, the artery and vein were divided. The animals were then randomized into four groups as follows: In group I (N=16), the artery was repaired and then the clamps were released to revascularize the flap. Venous stasis occurred as the vein was being repaired because of the venous clamp. In group II (N=15), the artery was repaired, but the clamp was maintained to prevent blood from coming in contact with the fresh arterial anastomosis and to prevent venous stasis. The ...Continue Reading

Citations

Nov 21, 2007·The Journal of Surgical Research·Hamza KayaIbrahim Astarcioglu
Jul 14, 2005·Journal of Vascular Surgery·Ioannis Prionidis, Tom F Browne
Sep 23, 2000·British Journal of Plastic Surgery·E OlssonR Lassila
Nov 1, 2005·Annals of Plastic Surgery·Serdar NasirMeltem Ozgüner
Apr 4, 2006·Plastic and Reconstructive Surgery·Leonardo SartoreFranco Bassetto
Feb 27, 2015·Plastic and Reconstructive Surgery·Kenneth L FanKaren K Evans

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