bluuebunny/crossref_metadata_2025 huggingface dataset:
A new technique for end‐to‐end ureterostomy in the rat, using an indwelling reabsorbable stent
Authors: Carmignani Giorgio , Farina Furio Pirozzi , De Stefani Stefano , Maffezzini Massimo
Published: March 2007

The restoration of the continuity of the urinary tract represents one of the major problems in rat renal transplantation. End‐to‐end ureterostomy is the most physiologically effective technique; however, it involves noteworthy technical difficulties because of the extremely thin caliber of the ureter in the rat and the high incidence of postoperative hydronephrosis. We describe a new technique for end‐to‐end ureterostomy in the rat, where the use of an absorbable ureteral stent is recommended. A 5‐0 plain catgut thread is used as a stent. The anastomosis is performed under an operating microscope at × 25–40 magnification with interrupted sutures of 11‐0 Vicryl. The use of the indwelling stent facilitates the performance of the anastomosis and yields optimal results. The macroscopical, radiological, and histological controls in a group of rats operated on with this technique showed a very high percentage of success with no complications, a result undoubtedly superior to that obtained with conventional methods.
An experimental model for lymphedema in rabbit ear
Authors: Gong‐Kang Huang , Yuan‐Pai Hsin
Published: March 2007

A simple, inexpensive method for producing an experimental model for lymphedema in rabbit ear is described. In 47 of 50 rabbit ears, the lymphedema could be demonstrated by measurement of ear thickness, water displacement, skin thickness, diameter of lymphatics, and histopathology of the experimental ear. Three rabbit ears failed because of technical reasons. In studying the findings of experimental lymphedema, some clinical phenomena are explained and modifications of the operative procedure of microlymphaticovenous anastomosis for treating lymphedema are suggested.
A modified technique to make a portacaval shunt in rats
Authors: Numata Minoru
Published: March 2007

A simplified technique to make an end‐to‐side or a side‐to‐side portacaval shunt in rats is described. The method requires no expensive special microsurgical instruments, and when the technique is completely mastered, one can make a portacaval shunt within 10 minutes. This is very useful when making many experimental models in rats. Moreover, this technique is fundamental for doctors who are intending to train in microsurgery.
One hundred percent patency of one‐millimeter polytetrafluoroethylene (Gore‐tex) grafts in the carotid arteries of rats
Authors: Cuadros C. Luis
Published: March 2007

Expanded polytetrafluoroethylene arterial interposition grafts with an internal diameter of 1.0 mm were placed in the carotid arteries of rats. At 2 weeks, 100% patency rate was achieved by the use of strict sterile technique in 23 rats. In contrast, only 1 out of 21 grafts remained open in rats operated using standard clean but nonsterile technique, 5% patency. All thrombosed grafts showed evidence of infection. Orally administered aspirin at therapeutic doses prolonged bleeding times in the rats but did not affect patency results in either group.
Comparison of suture technique on patency of polytetrafluoroethylene‐microarterial anastomoses
Authors: Kon Neal D. , Martin Matt B. , Meredith J. Wayne , Meredith Jesse H.
Published: March 2007

Polytetrafluoroethylene (PTFE) grafts, 1 mm in internal diameter, were interpositioned in the infrarenal aortas of 20 adult Sprague‐Dawley rats with either continuous or interrupted sutures. The interrupted‐suture (I‐S) technique was used in ten rats, the continuous‐suture (C‐S) technique in the other ten. After followup of 90 days, the overall patency rate for the 20 rats was 95% (19/20); all grafts in the C‐S group were patent; one graft in the I‐S group had occluded on the day of operation. Since excellent patency rates were obtainable with these minute PTFE grafts placed in the rat aorta by either technique, the speed with which the C‐S technique can be accomplished appears to make it preferable.
Microvascular free bone transfer: Experimental technique on rat's femur
Authors: Schoofs M. , Cariou J. L. , Amarante J. , Panconi B. , Bovet J. L. , Baudet J.
Published: March 2007

A technique of microsurgical femur transplantation on rats is presented. This experimental model is used for better understanding of the bone physiology in autotransplantation and in homotransplantation.
Experimental foetal microsurgery as related to myelomeningocele
Authors: Brunelli G. , Brunelli F.
Published: March 2007

To study the capacity of embryono‐foetal tissue to regenerate without scar formation, experimental intrauterine surgery has been carried out in rabbits. This study has been performed with regard to the possibility of using intrauterine microsurgery to correct myelomeningocele in humans to avoid scar adhesion between the medulla and the growing vertebral bones and subsequent hydrocephalus. Lesions were produced in the spinal cord of rabbit foetuses, and observation after birth showed repair without scar formation. Further research is in progress to confirm these findings and to adapt this procedure to the clinical situation.
Microsurgical spermaticoepigastric anastomosis for treatment of varicocele
Authors: Belgrano Emanuele , Puppo Paolo , Quattrini Stefano , Trombetta Carlo , Pittaluga Paolo
Published: March 2007

For varicocele correction, the occlusion of the internal spermatic vein is commonly performed, leaving the testis without its major pathway. Microsurgery offers the possibility to create a new venous drainage to the testis by anastomosing the internal spermatic vein with the inferior epigastric vein. Both stumps of the epigastric vein can be alternatively used, according to the different pathogenic mechanism of the varicocele. Eight patients with left varicocele were operated on using this new technique, with satisfactory results.
A new type of alloplastic spermatocele: The bridge spermatocele
Authors: Puppo Paolo , Belgrano Emanuele , Gaboardi Franco , Trombetta Carlo
Published: March 2007

A new type of artificial spermatocele is proposed. A Gore‐tex cylinder is sutured to the tails of the epididymides making a bridge between the two testes. The advantages of this spermatocele are (1) use of a single puncture; (2) easy execution of the puncture because the bridge stabilizes and holds the testicles in place; (3) a greater quantity of aspirate and, therefore, easier conservation of sperm; (4) a better quality of aspirate; and (5) relative ease of the surgical procedure.
Technique of end‐to‐side portacaval shunt in fish (scyliorhinus canicula: Small dogfish)
Authors: Louis D. , Mouriquand P. , Clement G. , Rigal A. , Peres G.
Published: March 2007

The authors describe a technique of portacaval shunt in a fish (small dogfish) using microsurgery. The techniques of anaesthesia and surgery are described and the results of eight operations are given, which show the problems of this kind of surgery, particularly with healing.
The foliage leaf in microvascular surgery
Authors: Kaufman Theodor , Hurwitz Dennis J. , Ballantyne Donald L.
Published: March 2007

A lacerated fresh leaf is introduced as a model for developing and refining microvascular skills. Being friable, this plant tissue exaggerates damage due to technical errors, therefore improving a trainee's skills.
Continuous‐and interrupted‐suture technique in microsurgical end‐to‐end anastomosis
Authors: Firsching R. , Terhaag P. D. , Müller W. , Frowein R. A.
Published: March 2007

Microsurgical end‐to‐end anastomosis of the carotid artery of the rat is discussed. The continuous‐suture technique is found to be less time consuming than the interrupted‐suture technique. Comparison of the flow rate of each anastomosis doesn't reveal a marked difference. Patency rate of each technique is 100%.
Objective control of replanted fingers by transcutaneous partial O2 (PO2) measurement
Authors: Keller H. P. , Lanz U.
Published: March 2007

Transcutaneous PO2 measurement is a suitable means of confirming the healing of replanted fingers. The method allows continuous monitoring of blood circulation; therefore, failing blood circulation in replanted fingers can be detected early.
Microsurgical tubal anastomosis: A controlled trial in four asian centers
Authors: Rock John A. , Chang Yoon S. , Limpaphayom Kobchitt , Koetswang Surporn , Moeloek F. A. , Guzick David S. , Burkman Ronald T. , King Theodore M.
Published: March 2007

An international program to determine the reversibility of female sterilization in Asia using microsurgical technique was established in 1980. One hundred eleven of 219 patients (51%) conceived following tubal anastomosis; of these, 79 delivered living children. The overall cumulative probability of conception at the end of follow‐up, as determined by life‐table analysis, was 63%. A decreased pregnancy rate was associated with anastomosis of tubes sterilized by electrocautery methods.
Physiologic isolation of the canine proximal fibular epiphysis on a vascular pedicle
Authors: Nettelblad Hans , Randolph Mark A. , Weiland Andrew J.
Published: March 2007

In order to create a model for epiphyseal growth plate transplantation by microvascular technique, a well‐defined donor site was established. Dissection of latex‐injected adult and juvenile dogs established the vascular supply to the proximal canine fibula. By isolating 7 cm of proximal fibula on the popliteal vessels, the nutrient supply to the epiphyses, metaphysis, and diaphysis is retained. This preserves the nutrient arterial supply to the fibula originating from the cranial tibial artery, the caudal tibial artery, and the small blood vessels from these to the epiphysis. Perfusion of the graft through the defined vascular pedicle was confirmed using 141Ce‐labeled microspheres. These results showed a perfusion of the established graft that was as great as or greater than the control, unoperated side. It is concluded that the technique described for isolation can be used for developing a model for vascularized transplantation of epiphyseal growth cartilage in canines.
Experience with epigastric free flap transfer in the rat: Technique and results
Authors: Ruby Leonard K. , Greene Mark , Risitand Giovanni , Torrejon Ricardo , Belsky Mark R.
Published: March 2007

We have described the advantages and disadvantages of using the rat epigastric free flap as a means of studying transplantation phenomena. The study comprises 20 epigastric free flap autografts in rats. After 11/2 years of working on the model, we achieved a 75% success rate in the last 20 consecutive procedures. From our experience with this model, we feel that the rat epigastric flap has a place in the study of transplantation phenomena in the experimental laboratory. In addition, we feel that this is an excellent technical exercise for maintaining proficiency in performing microvascular anastomoses.
A microminiature photoplethysmograph probe for microvascular surgery
Authors: Doyle D. John , Eng Masc, P.
Published: March 2007

A new microminiature photoplethysmograph probe suitable for vascular monitoring of replanted digits and toe‐to‐thumb transfers is described.
Microscopic anatomy of the adult human brachial plexus: An anatomical and histological basis for microsurgery
Authors: Bonnel F.
Published: March 2007

On the basis of 100 brachial plexus dissections in adult subjects, the angular variations of roots in their intrarachidian and cervical portions are examined. Serial histological sections of 21 brachial plexuses allow one to define fascicular histologic organization. These descriptions of biometric anatomical variation and complexity in histological fascicular organization help to elucidate the difficulties that must be overcome following nerve suture in order to achieve a satisfactory functional recovery.
Efficacy of polyglycolic acid (Dexon) microsutures in peripheral nerve anastomoses in the rat: 2. Perineural suture
Authors: Lee Sun , De Macedo A. R. , Hweidi S. A. , Bacchi C. E. , Wolf Paul
Published: March 2007

In 48 rats, bilateral sciatic nerves were severed and perineuriums were resutured with Dexon 10‐0 sutures. Animals were sacrificed at days 7, 14, 21, and months 2,3, and 6. The nerve segments exhibited an acute inflammatory cellular reaction to the sutures during the early period. The inflammation gradually subsided. However, the inflammatory foreign body giant cells still remained around the sutures for as long as 68 days, after which they were not present. In the additional eight rats with nylon suture anastomoses of the perineurium of the sciatic nerves, a foreign body giant cell reaction was present combined with a lymphocytic cellular infiltrate surrounding the suture for 6 months postoperatively. It is concluded that Dexon microsuture is less reactive than nylon in perineural anastomosis of severed nerve.
Resection and anastomosis of a cervical vertebral artery aneurysm
Authors: Clark Jonathan B. , Six Eric G. , Early Calvin B.
Published: March 2007

A patient with a fusiform aneurysm of the cervical vertebral artery at C‐1 presenting with posterior circulation infarctions is reported. Exposure via the posterolateral approach, resection of the aneurysm, and end‐to‐end anastomosis are described. The authors emphasize the importance of the surgical approach and ability to expose and mobilize a generous portion of the cervical vertebral artery.
Observations on the effects of CO2‐laser on rat myocardium
Authors: Owen Earl R. , Canfield Paul , Bryant Ken , Hopwood Paul R.
Published: March 2007

The effect of CO2‐laser burn on rat myocardium was studied to evaluate a hypothesis developed by Mirhoseini and Cayton1 that infarcted myocardium may be revascularized by establishing an alternative circulation from a ventricle to the coronary arteries by means of laser channels burned through the myocardium. The hearts of 22 rats were examined histologically for a period ranging from a few minutes to 50 days after CO2 laser was applied to the myocardium. The laser initiated an intense inflammatory response in the myocardium adjacent to the target site. The authors believe that the inflammatory response, observed in this study to the Biophy‐Las 80 surgical laser, must be reduced if laser is to be an effective means of myocardial revascularization.
A training card for microsurgery
Authors: Awwad Awad M
Published: March 2007

A training card for microsurgery is described which could be useful for beginners. The card is light in weight, inexpensive to produce, easy to use, and can be preserved as a record of progress.
The free vascularized sural nerve graft
Authors: Doi Kazuteru , Kuwata Noriyuki , Kawakami Fujio , Tamaru Khoichi , Kawai Shinya
Published: March 2007

The sural nerve was described as a new donor nerve of the free vascularized nerve graft in a fresh cadaver's dissection and in four clinical cases. The vascularized sural nerve is nourished by the cutaneous branch of the peroneal artery or the muscular perforating branch of the posterior tibial artery in our grafts. Compared to other vascularized nervegrafts, the sural nerve has many advantages: 1) A “two‐ or three‐fold nerve graft” can be designed on itself without damage to the blood supply of the nerve, 2) survival of the nerve can be reasoned by the accompanying flap and the flap can close the skin defect simultaneously without additional vascular anastomosis, and 3) sensory loss at the donor site is negligible. The final extent of sensory recovery in our clinical cases could require several months, but a quickly advanced Tinel's sign suggested the technique's superiority.
A vascularized fibula model to study vascularized canine bone grafts
Authors: Shaffer John W. , Field Gregory A. , Goldberg Victor M. , Zdeblick Thomas A.
Published: March 2007

We have refined the experimental canine vascularized fibula model in 26 dog experiments. Our results have demonstrated that both periosteal and endosteal blood flow are retained following end‐to‐end anastomosis of the bone graft pedicle artery and vein. The success of this model depends on detailed knowledge of the surgical anatomy and upon meticulous microvascular surgical technique.
Lesions of the kidney in tourniquet shock: Ultrastructural study
Authors: Orsi R. , Brunelli G. , Zorzi F.
Published: March 2007

Light microscope and ultrastructural changes in the rat kidney in tourniquet shock are described. The animals (24) were divided into two series; in the first one, the hind limb was kept at room temperature; in the second series, prerefrigeration was used. The effects of different ischemia were studied (2,4,8, and 12 hours for warm ischemia; 4,8,12, and 16 hours for cold ischemia). The animals were sacrificed at 3, 10, and 30 days. Pathological changes were evident, consistingin an increase of cytosomes in the proximal tubules and apical vacuolation in collecting ducts; numerous cytosomes including myelin‐like structures were also seen. Large differences between warm and cold ischemia alterations were found. The changes in the tubules were clearly less important in cold ischemia. The authors conclude that there is a protective effect in regard to prevention of renal pathology affordable by prerefrigeration of a limb for reimplantation.
Surgical management of endometriosis with the carbon dioxide laser
Authors: Bellina Joseph H. , Voros Janos I. , Fick Correa , Jackson Jeff D.
Published: March 2007

This study was designed to evaluate the efficacy of reconstructive microsurgery with the carbon dioxide laser for thetreatment of infertile women suffering from endometriosis. One hundred and eight women evaluated for infertility and endometriosis underwent reconstructive microsurgery with the carbon dioxide laser. All cases were classified in accordance with the American Fertility Society's classification. Postoperatively, conception rates for the mild‐to‐moderate and the severe‐to‐extensive groups were estimated by life table methods for analysis. Estimates ofthe cumulative pregnancy rate were 55% for the mild‐to‐moderate group and 88% for the severe‐to‐extensive group. The abortion rate was 17% and the ectopic pregnancy rate was 3%.
Rotational technique and microsurgery
Authors: Weinrib Harry P. , Cook John Querin
Published: March 2007

A rotational technique to manipulate microsurgical instruments has several advantages. Tremor is suppressed, the hands remain relaxed for long periods of time, and the nondominant hand is able to play a more active role in the operation. The fundamentals of rotational technique are discussed.
The microneedleholderscissors and the microforceps
Authors: Owen Earl R.
Published: March 2007

Two new Australian‐designed instruments for microsurgery are described. These are a combination microneedleholder and scissors, and a versatile microforceps. With one of these combination instruments in each hand no additional equipment is needed for a microanastomosis of any small vessel, tube, or nerve. Ergonomically designed for the penholder handgrip their use considerably reduces the time of microanastomosis and does away with the need for both a skilled assistantand an expensive double‐operating microscope.
Rotation of scissors while fixed in the microsurgical field: A technique for increasing the surgeon's efficiency
Authors: Greenberg I. M.
Published: March 2007

The use of mechanical support for scissors during microsurgery reduces tremor and improves the surgeon's efficiency. Rotation of such a pair of mechanically supported scissors presents further improvements as it permits the surgeon to cut in all directions while reducing the need for time‐consuming instrument transfers. Thus, one pair of scissors can be kept within the field and rotated to the required orientation for cutting.
Sutures or fibrin glue for divided rat nerves: Schwann cell and muscle metabolism
Authors: Becker Corinne M. , Gueuning Christiane O. , Graff Guy L.
Published: March 2007

Peripheral nerve anastomoses using either epiperineurial sutures or a fibrinogen adhesive technique have been compared in the rat sciatic nerve model. Evaluation of results was made using radiolabelling of the metabolically active acid‐soluble phosphate fractions of both nerve and muscle. In none of the situations tested‐traumatic degeneration and regeneration in the sciatic nerve proximal segment, Wallerian degeneration and regeneration in its distal segment, atrophy and regeneration of the fast gastrocnemius muscle, and atrophy and regeneration of the slow soleus muscle‐was one repair method significantly superior to the other. A significant degree of cross‐reinnervation was shown to take place after anastomosis, altering the characteristics of the regenerating muscles. Both repair methods were equally inferior to the spontaneous repair occurring after a simple nerve crush.
Laser doppler surveillance of the circulation of free flaps and replanted digits
Authors: Hedén Per G. , Hamilton Richard , Arnander Claes , Jurell Göran
Published: March 2007

In a series of 40 clinical free flaps and replantations the laser doppler technique has been used successfully for postoperative surveillance of circulation. A uniform flow pattern was obtained from all uncomplicated cases contrasting to the flow pattern seen in cases with thrombotic complication. The laser doppler continuously records flow of the microcirculation and is able to monitor blood flow in all types of free tissue transfer presently used as well as replantations. The laser doppler has effectively diagnosed two arterial thromboses with a characteristic flow pattern. It can distinguish venous from arterial occlusion. It can record flow in skin flaps which are difficult to judge clinically and in buried flaps, where no clinical observations are possible. The laser doppler should be used in conjunction with routine clinical observations.
Evolution and reversibility of damage to rabbit fallopian tubes after five sterilization methods
Authors: Garcea Nicola , Dargenio Ruggero , Santucci Antonio , Panetta Vincenzo
Published: March 2007

The authors used a scanning electron microscope to study epithelial damage to the rabbit fallopian tube after sterilization with different methods and its subsequent capacity to regenerate after recanalization. Thirty female NZW rabbits were divided into five groups and sterilized using the following methods: (1) Madlener (2) Pommeroy, (3) clips, (4) unipolar coagulation, (5) bipolar coagulation. Each group was divided into subgroups of two and submitted at differing intervals to a second laparotomy, during which one tube was removed and the other anastomosed according to Winston's method. Four weeks after the second laparotomy all the rabbits were sacrificed, the remaining tube removed, and all tubes examined with the scanning electron microscope. The results indicate that mechanical methods of occlusion such as clips offer greater recovery possibilities than those in which the lesion is extended to the mesosalpinx. There further exists a correlation between the time that elapses after sterilization and regeneration of the epithelium.
Lymphedema in the replanted limb of the rat: Scintigraphic evaluation
Authors: Kramer Elissa Lipcon , McLaws Robert , Sanger Joseph J. , Shaw William
Published: March 2007

The sequence of scintigraphic patterns in resolving lymphedema in the replanted hind limb of the rat is reported. Compared to simple observation of the limb, scintigraphy using 99mTc‐antimony trisulfide colloid (99mTc SbSC) provides multiple qualitative parameters for assessing lymphedema, ie, diffuse uptake in the implanted limb, focal uptake at the site of surgical repair, accumulation in the popliteal node, and activity in the liver. Quantitative analysis in this model was not helpful. Scintigraphic criteria may be utilized to study the effect of alteration in the animal model described. It is hoped that this model can be used to clarify the clinical factors influencing the resolution of lymphedema.
Immediate and prolonged effects of dihydroergocryptine after experimental vascular microsurgery
Authors: Merle Agrügé M. , Restrepo Y. , Benharkate M. , Legeai J.
Published: March 2007

An animal model of limb replantation has been utilized in order to evaluate the effects of dihydroergocryptine (DHEC, 0.1 mg/kg I.V.) on arterial and peripheral tissular blood flows after reperfusion. DHEC is a partial agonist of adrenergic receptors and is therefore liable to exert an action on arteriovenous shunts that remain abnormally opened after ischaemia. DHEC showed important efficacy in this model, increasing, in low doses, blood flow in sutured artery and peripheral tissue.
A digit replantation model
Authors: Haines Peter , Nichter Larry S. , Morgan Raymond F. , Horowitz Jed H. , Edgerton Milton T.
Published: March 2007

A simple, inexpensive, reproducible, and reliable model for digital replantation is described utilizing the rabbit ear. When compared to the human digit, it provides benefits over previous models. It is of similar tissue type and characteristics. The vessels closely approximate the digit in size and number. Results are easily quantified and the opportunity for a paired control in the same animal exists. Therefore, experimental design and statistical calculations may be simplified. The model can function for either replantation or revascularization with only slight changes in its preparation. Survival rates have been over 90%. In addition, the model provides an excellent forum for the development of technical expertise in the aspiring microvascular surgeon.
Free vascularized nerve grafts: An experimental study in the rabbit
Authors: Restrepo Yolanda , Merle Michel , Michon Jacques , Folliguet Bernard , Barrat Edouard
Published: March 2007

An experimental animal model of a vascularized graft is presented as an alternative to recover faster function. The technique is described and the model compared to a conventional graft in the sciatic nerve of a rabbit. Results are evaluated with histological studies and quantified using a computer to measure the thickness of the myelin sheath as a correspondence factor of regeneration. Results showed a more favorable regeneration when a vascularized graft was used.
Evaluation of patency of synthetic and autogenous venous and arterial micrografts in rats
Authors: Musella Rosario A. , Willey Edward N.
Published: March 2007

Long‐term patency rates of synthetic and autogenous venous and arterial microvascular grafts in rats were compared. The grafts were interposed between the carotid arteries. The geometry of the anastomoses was designed in a manner intended to be comparable to the situation commonly encountered in cerebral revascularization procedures in man. Patency rates were 37.5% for synthetic grafts, 90% for venous grafts, and 60% for arterial grafts. Venous grafts are the best currently available microvascular prostheses.
Relationship of costs and real advantages of microsurgery in urology
Authors: Wagenknecht L. V.
Published: March 2007

The cost‐advantage relationships in the use of microsurgical equipment and techniques in various medical fields are examined. Cost‐effectiveness in clinical urology appears to support the use of microsurgery. Specific applications to urethroplasty, pyeloplasty, renal stone surgery, and renal trauma, are discussed.
An experimental study of the effect of infection on microvascular anastomosis
Authors: Luk K. D. K. , Chow S. P.
Published: March 2007

The effect of penicillin‐resistant Staphylococcus aureus infection on the patency of microvascular anastomosis was studied in an experimental model. Histological and SEM studies were also performed. It was found that the presence of infection did not significantly lower the patency rate of rat femoral artery re‐anastomosis.
Enhancement of blood flow in experimental microvascular free flaps
Authors: Weinberg Hubert , Song Yeliang , Douglas Barry
Published: March 2007

Prolonged ischemia may result in tissue death because of the no‐reflow phenomenon. By raising a flap 24 hours prior to subjecting it to ischemia, the authors have been able to significantly lengthen the ischemia interval prior to the onset of tissue death. These effects are believed to be the result of alteration of the no‐reflow phenomenon.
A comparative study of autologous peripheral nerve grafts
Authors: Hafiz Mustafa , Lee Sun , Wolf Paul , Haghighi Parviz
Published: March 2007

Forty‐five Sprague‐Dawley rats were divided into four groups. The first two groups were subjected to primary epineural anastomoses, with and without tension. In the remaining two groups, sciatic nerve defects were produced and femoral cable grafts were then performed with and without making an epineural sheath defect on the edge of the recipient nerves. Five functional evaluation criteria (sensation, push‐off, fanning of claws, cubital ulcer, and leg atrophy) were used along with histological findings. It has been found that the recovery of sensation was the least in the tension group, as was other functional recovery. Animals with epineural and fascicular sutures ranked highest in functional recovery while cable grafts followed at 4th, 10th, and 12th week of observation.
A histologic comparison of continuous and interrupted microarteriorrhaphy
Authors: Joos Karen M. , Blair William F. , Maynard Jerry A.
Published: March 2007

Interrupted and continuous microsuturing techniques were compared 3 weeks after microarteriorrhaphy in the rat femoral artery using light microscopy, and internal luminal diameter determinations were measured with a Bio Quant II Digitizer. The histologic appearance of the arteries of both groups was similar, with intimal hyperplasia, intimal incorporation of suture projections into the lumen, minimal inflammatory response to suture material, and restoration of the media. No significant difference was demonstrated between internal diameters at the anastomosis site for the continuous (N = 11, mean diameter 804 ± 60 μm) and interrupted (N = 11, mean diameter 901 ± 45 μm) groups. However, the experimental arteries in both continuous and interrupted groups were significantly dilated when compared to their controls (513 ± 41 μm and 621 ± 44 μm, respectively). This study indicated that interrupted and continuous suture techniques in laboratory microarteriorrhaphy result in similar histologic and morphologic characteristics, and that the repaired vessels were dilated compared to intact vessels.
Fibrinolytic activity following laser‐assisted vascular anastomosis
Authors: Bailes Julian E. , Quigley Matthew R. , Kwaan Hau C. , Cerullo Leonard J. , Brown J. Thomas
Published: March 2007

New technology has allowed tissue bonding to be feasible using carbon dioxide laser energy. Laser‐assisted vascular anastomosis (LAVA) has shown comparable patency results with standard suture anastomosis, but LAVA procedures produce thermally induced transmural structural alterations. To assess functional intimal recovery in LAVA versus sutured vessels, a fibrinolytic slide technique was utilized in 21 rats which had LAVA performed in one femoral artery while the opposite limb underwent a conventional microsuture anastomosis. Conventional anastomosis had persistent fibrinolytic activity while LAVA had return of fibrinolytic activity by 48 hours. Intimal fibrinolysis inhibition following LAVA is reversible and this technique does not lead to an increased incidence of thrombosis.
Vascularization of tricalcium phosphate, an artificial bone substitute: Preliminary observations
Authors: Angel Michael F. , Swartz William M. , Ramasastry Sai S. , Brown Mary Lynn , Hanley Edward N. , Herbert David L.
Published: March 2007

Tricalcium phosphate (TCP), a biodegradable artificial bone substitute, was used to study the following questions: (i) can TCP be vascularized; (ii) do ectopically placed implants have osteoinductive capacity; and (iii) does vascularization affect implant resorption?

Implants were placed in dogs in several areas: (i) subcutaneous controls; (ii) wrapped with latissimus dorsi muscle; (iii) wrapped in omentum; (iv) saphenous and thoracodorsal av pedicles threaded through implant. Prior to harvest, animals were given tetracycline and implants were harvested at 3, 6, and 9 weeks. Microfil was injected prior to sacrifice and specimens were xeroradiographed. Histology and computerized axial tomography were obtained. From this study, we conclude that (1) TCP can be vascularized; (2) the most effective method of vascularization was by an AV pedicle threaded through the implant; (3) vascularized implants did not have osteoinductive properties per se, and (4) in the time observed no difference in implant resorption was demonstrated between the test groups.
Experimental study of lymphatic contractility in lymphedema and its clinical significance
Authors: Wang Guo‐Ying , Zhong Shi‐Zhen
Published: March 2007

Fifty‐four rats that had been used as models for lymphedema were divided into nine groups to observe the changes of lymphatic contractility in pathologic conditions at varying postoperative days. The changes of the lymphatic contractility were divided into three stages in this paper: In the first stage, the lymphatic contractility was impaired by high intralymphatic pressure, but the morphology of its wall was normal and it could recover its function if the pressure was decreased. In the second stage, the blocked lymphatic lost its contractile function partially or completely because its wall thickened and fibrosed, but the newborn lymphatics possessed contraction function and could be anastomosed. In the third stage, most lymphatics had lost their contractile function because of severe fibrosis. The fibrosis of the tissue even blocked the growth of the newborn lymphatics. In this stage, therefore, it was unsuitable to do a lymphatic‐venous anastomosis. It can be concluded from the experiment that lymphatic contractility should be considered before performing a lymphatic‐venous anastomosis. The lymphatic that still has contractile function should be selected for lymphatic‐venous anastomosis.
A model of experimental lymphedema in rats' limbs
Authors: Wang Guo‐Ying , Zhong Shi‐Zhen
Published: March 2007

The authors' modified Olszewski method (J Cardiovasc Surg 9:178–183, 1968) for preparing chronic lymphedema with rats' limbs is presented. The incidence of chronic lymphedema formation after 9 months of follow‐up was 64%. The experiment demonstrates that there is a brisk regeneration of the lymphatics under the lymphedema. The regeneration observed took place on the lateral wall of the blocked lymphatics, except for regeneration of capillary lymphatics, and the newborn lymphatics grew about 1 mm each day. There are indeed preexisting lymphatics in the body. They are of significant importance in the establishment of the collateral circulation because of their great number and early opening. Lymphatic regeneration and opening could be prevented by tissue scarring. Effective prevention of the formation of tissue scarring has important significance in preventing the development of chronic lymphedema.
Microsurgical application of freeze‐dried venous allografts
Authors: Pratt Michael F. , Schneider James , Norris Michael S.
Published: March 2007

Freeze‐dried venous interposition allografts with an internal diameter of 1.0 mm and a length of 1.0 cm were placed into the femoral arteries of 17 Sprague‐Dawley albino male rats in order to investigate patency and host tissue response. The immediate patency rate was 88%. The epigastric island flap was monitored as a sign of patency in the early postoperative period (defined as 1 to 3 days). Twelve of the 17 subjects were observed for 2 months, at which point 66% (8/12) remained patent. There were two aneurysmal dilatations. Histopathological studies and transmission electron microscopy demonstrated that freeze‐dried veins undergo complete remodeling in vivo by a normal reparative process and that they do not induce a cellular immune response in the host.
Rat epigastric pedicle model: A clinically relevant evaluation of 1‐mm ptfe grafts
Authors: Barttelbort Scott W. , O'leary Michael J. , Schneider James , Woodruff Woody
Published: March 2007

Twenty‐eight Sprague‐Dawley rats had 1.0‐mm polytetrafluoroethylene (PTFE) interposition grafts placed in their femoral artery that supplied a 3.0 × 3.0 cm epigastric pedicle flap. The model is the first to evaluate 1.0‐mm PTFE under rigorous, clinically simulating conditions. Anastomoses employed a new, continuous telescoping suture technique. Grafts were selected for histological and electron microscopic evaluation, which confirmed the development of a cellular neointimal lining. Viability of the flap model had a 90% correlation with graft patency. Overall graft patency was 50%. Patency was documented in some specimens harvested at 200 days. The flap model is a good indicator of graft patency. PTFE grafts of 1.0‐mm internal diameter are not yet equivalent to autologous veins. Future refinements, particularly aseptic technique, are expected to result in even higher patency rates.
Experience with epigastric free flap allograft in the rat
Authors: Ruby Leonard K. , Greene Mark , Risitano Giovanni
Published: March 2007

We report our continuing experience with the rat epigastric free vascularized flap as a transplant model. Four groups of ten pure‐bred rats underwent transplantation of epigastric vessel based skin flaps. The flaps were immediately revascularized in the recipient animal and the results recorded. No immunologic manipulation was performed. Rejection and acceptance of the flaps occurred according to known genetic predictions in these 40 procedures. This study will serve as a control for immunologic manipulation experiments.
Ischemic induction of neovascularization: A study by fluorometric analysis
Authors: Semashko Denise , Song Yeliang , Silverman David G. , Weinberg Hubert
Published: March 2007

The dynamic process of skin flap neovascularization can be quantitated in a relatively non‐invasive fashion in an „in‐vivo”︁ model using the technique of perfusion fluorometry. The extent of skin flap ischemia can be monitored, and its effect on angiogenesis rapidly determined. Evidence is presented that indicates that angiogenesis develops from a distal to proximal direction corresponding to the degree of ischemia as measured by fluorescein uptake and elimination. Furthermore, although certain proximal segments of skin flaps demonstrated no uptake or elimination, survival could still occur, indicating that neovascularization need not be complete at the time of pedicle interruption.
Extraintracranial anastomosis performed by means of biological gluing materials: Experimental and clinical study
Authors: Aksik I. A. , Kikut R. P. , Apshkalne D. L.
Published: March 2007

A new surgical technique of extraintracranial anastomosis (EIA) is reported. End‐to‐side microvascular anastomosis is performed by applying four crossed‐fixing sutures and by mantling a hemostatic sponge muff (eg, Spongostan) impregnated with fibrinogen‐thrombin glue. Histopathological studies of microvascular anastomosis in animals and clinical results of 70 EIA operations showed that this surgical technique of anastomosis has certain advantages, namely that it reduces the number of sutures needed, is less traumatic to the vascular wall, ensures elastic vascular junction, and the glue and Spongostan used possess high biological inertness that provides a better physiological connection of vessels than conventional suturing. The highly hermetic vascular junction and absence of blood flow at the anastomosis site are achieved without additional suturing. The duration of the operation is significantly reduced. A full EIA function sets in comparatively early.
The inner prosthetic surface structure and re‐endothelization: An experimental study in the rat using two types of microvascular prostheses for aortic implantation
Authors: Hess F. , Jerusalem C. , Braun B. , Grande P.
Published: March 2007

Two types of microvascular prostheses were implanted in the rat infrarenal aorta. Operations were carried out with clean, nonsterile instruments under ether anesthesia. Anastomoses were made with a continuous 8‐0 suture. In group A, a 1‐cm‐long piece of expanded polytetrafluorethylene (PTFE) and in group B a 1‐cm‐long fibrous polyurethane prosthesis were implanted. Both groups consisted of 18 rats. Three rats from each group were killed at days 3, 5, 10, 20, 40, and 60 postimplantation. Prostheses were examined by scanning electron and light microscopy for the re‐endothelialization. All prostheses in both groups were patent at the time of death. Reendothelialization started in both types of prostheses the fifth day after implantation and had advanced 1–3 mm in the PTFE prostheses at day 60. However, in the fibrous polyurethane prostheses, re‐endothelialization progressed and a complete new lining was achieved between days 20 and 40 postimplantation. The endothelium/neointima in the fibrous prosthesis was firmly anchored onto the prosthetic wall by means of cellular protrusions between the polyurethane fibers. In contrast to this observation, the endothelium/neointima developed in the PTFE prostheses was not anchored to the wall of the prosthesis. It is emphasized that the development of a new lining in a prosthesis may reduce the risk of endogenous, hematogenous infections. From the results of this study, we have concluded that there is a correlation between the inner surface structure and the extent of the reendothelialization of a prosthesis. A prosthesis with a fibrous structure is much more rapidly and completely re‐endothelialized than an expanded PTFE prosthesis.
Simultaneous reconstruction of bone and skin defects by free fibular graft with a skin flap
Authors: Minami Akio , Usui Masamichi , Ogino Toshihiko , Minami Michio
Published: March 2007

It has been very difficult to accomplish simultaneous reconstruction of a massive defect of the long bone associated with a large skin defect. Yoshimura et al reported a new procedure using a vascularized free fibular transplant with a monitoring flap. This procedure was used in four cases that had resulted in massive bone and skin defects after wide resection of benign and malignant bone tumors occurring in the long bones. Our results using the composite vascularized fibular graft were gratifying.
A new microsurgical reoperation for failed lumbar disc surgery
Authors: Goald Harold J.
Published: March 2007

This paper reports a consecutive series of 103 patients operated upon over a 4.2‐year period (from November 1978 through January 1983). These patients were initially operated upon by other orthopedic and neurologic surgeons without relief of their sciatic pain. The average duration of symptoms prior to microsurgical reoperation was 35.9 months. The average number of reoperations per patient was 1.4. The median follow‐up time was 27 months (range 1–50 months). Preoperative evaluation included examination, CAT scan, myelogram, and electromyeogram. Average postoperative hospital stay without spinal fusion was 5.1 days. Two techniques were used: a unilateral decompression and a bilateral intersegmental decompression. Results are compared. A classification of operative findings is given. Eight patients in the series received spinal fusion as part of their procedure. Microsurgical reoperation benefited 80.6% of the 103 patients.
Waveform analysis applied to laser doppler flowmetry
Authors: Fischer Joseph C. , Parker M. Paul , Shaw William W.
Published: March 2007

Laser Doppler flowmetry (LDF) has been found useful in monitoring free flaps. In the present study, waveform analysis has been applied to the LDF waveform. Waveform changes were investigated in the microcirculation during varying degrees of arterial or venous occlusion in the saphenous island and flap of the dog and the human digit. The quantitative analysis of laser Doppler flowmetry waveform allows for the diagnosis of arterial occlusion or venous occlusion and their differentiation.
Spiral interrupted suturing technique for microvascular anastomosis: A comparative study
Authors: Chen Lilly , Chiu David T. W.
Published: March 2007

This is an experimental study comparing the suturing time and patency rate of a spiral interrupted suturing technique to those of conventional interrupted and continuous suturing technique in end‐to‐end as well as end‐to‐side anastomosis. The spiral interrupted suturing technique requires less time for either end‐to‐end or end‐to‐side anastomosis than conventional interrupted suturing technique, and does not result in stenosis as shown in the venous end‐to‐end anastomosis by continuous suturing technique.
Experimental laser‐assisted end‐to‐side microvascular anastomosis
Authors: Sartorius Carl J. , Shapiro Scott A. , Campbell Robert L. , Klatte Eugene C. , Clark Steven A.
Published: March 2007

The authors present a new technique of end‐to‐side microvascular anastomosis in a rat carotid artery model, employing a milliwatt CO2 laser. Both carotid arteries were isolated and approximated in an end‐to‐side fashion by the placement of four 10‐0 nylon stay sutures. The milliwatt CO2 laser was used to effect vessel anastomosis between the sutures, using 70–100 mW of power. Animals were killed 8 weeks postoperatively. Angiography of each anastomosis was performed in all animals. All anastomoses were then harvested, and submitted for histological analysis. Anastomotic patency was 100%, both intraoperatively and angiographically. There was no evidence of intravascular thrombus, anastomotic stenosis, or pseudoaneurysm formation. Early in the experiment, some anastomoses showed localized dilatation at the anastomotic site. The histologic changes at the anastomotic site are described. Laser‐assisted microvascular anastomosis is a feasible technique, and a potential alternative to conventional suture techniques.
Hemodynamics after autogenous, interpositional grafting in small arteries
Authors: Blair William F. , Chang Laurette , Pedersen Douglas R. , Gabel Ronald H. , Bell Lawrence D.
Published: March 2007

This investigation initiates the quantitative, hemodynamic assessment of interpositional grafts in small rat arteries. The left femoral arteries in 16 Sprague‐Dawley rats were transected at two levels, and were then repaired using interrupted suturing technique. This effectively provided an ideally sized and histologically matched interposition graft. The 20‐MHz PUDVM method was used to measure blood velocities, and derive values for vessel lumen area, temporal mean of the spatial mean velocity (Vsm), and volumetric flows. Measurements were completed distal to the interposed graft. Variables were quantitated in the preoperative and at the 5‐, 15‐, and 30‐minute postoperative intervals. Statistical analysis of data indicated that the interpositional grafting procedure resulted in increased vessel lumen area and decreased Vsm, but, importantly, volumetric flow (about 8.20 ml/min) remained unchanged. This study demonstrated that, although hemodynamic characteristics are altered, volumetric flow can be restored after an experimental, interpositional grafting procedure in small arteries.
Successful transfer of “free” microvascular superficial temporal artery flap with no obvious venous drainage and use of leeches for reducing venous congestion: Case report
Authors: Lim Chai L.
Published: March 2007

A case is presented of “free” flap based on the frontal branch of the left superficial temporal artery and its surrounding soft tissues, without any proper vein for anastomosis, successfully transferred for eyebrow reconstruction. One can argue that this flap was a Wolfe graft. It probably was not for two reasons. First, “hairy Wolfe grafts” are always composite grafts with a thickness of 3–4 mm, as the base of the hair follicles lies in the subcutaneous tissue. Second, the edges of the flap were not sutured to the surrounding skin. Therefore, vascularization is unlikely from the surrounding skin and there was constant, definite oozing from the edge of this flap.