bluuebunny/crossref_metadata_2025 huggingface dataset:
Six models of heterotopic rat liver transplantation: Introducing a reverse circulation model
Authors: Lee Sun , Scott Michael H.
Published: March 2007

Six different models of heterotopic partial (30%) liver transplant techniques were enumerated step‐by‐step with the special introduction of a so‐called nonregenerative model in which the afferent blood supply to the liver graft was the host's systemic blood while the reverse circulation model was to receive the host's portal blood via the suprahepatic vena cava. The reverse circulation model needs further investigation as to its applicability, but the nonregenerative partial liver transplant model certainly deserves attention because of its importance for possible infusion studies using various hepatic nutrients, hormones, and enzymes.
Canine experimental free muscle transplantation
Authors: Stevanovic Milan V. , Seaber Anthony V. , Urbaniak James R.
Published: March 2007

Transplants of the cranial portion of the dog sartorius muscle were able to generate 70% of control force after 3 months if the artery, vein, and nerve were reanastomosed. Our histological and histochemical findings correlate with the functional findings. In a separate group of animals that had their muscles denervated prior to replantation, no collateral sprouting was noted and no function could be recorded when the nerve was stimulated proximally. These findings suggest that clinical application of free muscle transplantation is strongly supported by this animal model if due consideration is paid to surgical procedure and anatomical structure.
End‐to‐end and end‐to‐side microvascular anastomoses: A comparative study
Authors: Frodel John L. , Trachy Ronald , Cummings Charles W.
Published: March 2007

The decision to use an end‐to‐end versus end‐to‐side anastomosis remains a controversial issue in microvascular surgery, although it is generally accepted that certain clinical situations require skills in both techniques (eg, vessel size discrepancy or the need to preserve donor vessel distal flow).

Using rats, this investigation presents a unique free flap model comparing not only arterial end‐to‐end and end‐to‐side anastomoses, but venous anastomoses as well. There were 15 animals in each anastomoses group with a greater than 80% flap survival rate in each group. This supports findings of earlier studies that suggested no difference in survival when these two anastomosis types were compared.

Equally important was the assessment of dermofluorormetry as an immediate postoperative perfusion monitoring device. In this model, fluorometry was not found to be useful for predicting flap viability in an early period after completion of the anastomoses.
Modifications of the vein wall after microsurgical end‐to‐side artero‐venous anastomosis
Authors: Fox Umberto , Ferro Mario , Camozzi Luca , Conti Giario , Montorsi Walter
Published: March 2007

The repercussions on the venous wall of the creation of 20 artero‐venous anastomoses (AVA) between the femoral artery and vein of the rat have been evaluated. The rats were killed 7, 15, 30, and 90 days after AVA, and AVAs were examined by optical microscopy and by scanning electronic microscopy. Deposits of whitish material that nearly completely occluded the venous lumen were seen, especially in the group studied longer than 90 days. These venous wall lesions, which resemble arteriosclerotic lesions, must be attributed to the new hemodynamic situation created by the AVA. The implications of such findings for the long‐term validity of venous graft in vascular microsurgery and the long‐term patency of the AVA in hemodialyzed children are discussed.
Microvascular silicon replamineform grafts of 2‐ and 5‐cm lengths: Experimental studies
Authors: Berman David E. , Lineweaver William , Vasconez Beatrice , Buncke Harry
Published: March 2007

Replamineform silicone microvascular grafts 1 mm in diameter were cut to clinically useful lengths (2 and 5 cm) and used to reconstruct segments of the femoral artery in the rabbit. Despite initial patency and flow rates comparable to flow seen in vein graft repairs and primary repair, no longterm patency was observed. The theoretical biomechanical advantages of this kind of graft material have not solved the problem of long microvascular grafting.
Experimental study of regeneration of motor end plate
Authors: Zhasng Ling , Chen Zhong Wei , Haung Sui Ren , Ling Yi Ping
Published: March 2007

Twenty‐five Wistar rats and five dogs were used in this study. The common peroneal nerve connected with a segment of nerve graft was divided into fascicles or subfascicles and then inserted into the superficial muscular fibers of the lateral head of the gastrocnemius. The motor nerve supplying this muscle was deliberately cut away during the operation. Electrograms muscular strength, optic and electron‐microscopic, and histochemical examinations were studied 2 to 12 months postoperatively. New motor end plates and good muscular activity of the neurotized lateral head of the denervated gastrocnemius were demonstrated. This experimental result is useful for clinical applications of the method.
Practicability and reliability of model of cerebral infarction in dog by microneurosurgical technique
Authors: Weiguo Jiang , Shaoqing Li
Published: March 2007

The authors used somatosensory evoked potentials (SEPs) and the electron microscope to evaluate the practicability and reliability of a model of cerebral infarction produced by microneurosurgery in the dog. Complete cerebral hemisphere infarction was produced by occluding various vessels from the circle of Willis. After occlusion, there was a precipitous decrease in the amplitude of cerebral cortical components (85.65 ± 20.85 and 91.88 ± 24.59 μV before compared to 4.08 ± 1.99 and 2.85 ± 1.38 μV after occlusion, P <.001). The majority of the neurons at the 6th hour after occlusion became degenerated and contained no recognizable organelles.

This study shows that the occlusion of various vessels from the base of the brain by microneurosurgery could produce a practical, reliable model of infarction with a high rate of success. The size and location of infarction can be controlled, and it is suitable for intracranial microvascular research.
Scanning electron microscopic study of microvascular anastomoses on irradiated vessels: Long‐term effect of irradiation
Authors: de Wilde Rudy L. , Donders Gilbert
Published: March 2007

A study was performed to determine the effect of preoperative irradiation on microvascular arterial anastomoses. The study focused on microthrombi and epithelial regeneration. Using scanning electron microscopy (SEM), a clear difference was seen comparing nonirradiated to irradiated vessels. No difference was found between short‐ and long‐term effects of irradiation.
A comparison of continuous with interrupted sutures in microvascular anastomosis
Authors: Mao Kenneth , Tang Mai Y. M. , South John Roger
Published: March 2007

Microvascular anastomoses were performed on rat common carotid arteries using either continuous or interrupted sutures. The contralateral common carotid artery was ligated to create a demand situation. At 6 months, there was no statistically significant difference between the diameters of vessels anastomosed with continuous sutures and those with interrupted sutures.
Efficacy of dexon microsutures in rat major abdominal vessel anastomosis. I: Application to heterotopic heart transplant
Authors: Pempinello Ciro , Haghighi P. , Lee Sun , Curtis Guy P.
Published: March 2007

A total of 52 syngeneic heterotopic heart transplants were performed using 9‐0 Dexon microsutures to see if these anastomoses could be tolerable when challenged by the burden of transplanted heart and lung. Eighteen long‐term surviving transplants were verified by reliable ECG, Doppler tracings, and direct palpation of the heart grafts. Animals sacrificed at monthly intervals beginning 3 to 6 months posttransplantation were free of thrombus, lung abscesses, and separation at the anastomoses. Even though foreign body reaction was still present up to 5 months posttransplantation, no actual sutures were present after 3 months. From these observations, Dexon microsuture is acceptable in organ transplantation procedures.
Effect of dextran 70 and saline on thrombus formation following arteriotomy and intimectomy in small arteries
Authors: Wieslander Jan B. , Dougan Peter , Stjernquist U. , Mecklenburg C. V.
Published: March 2007

Twenty‐four arteries of rabbit ears, divided into three groups of eight, were prepared and 32P‐platelets injected. Arteriotomy (7 mm) and intimectomy (5 mm) were performed and in vivo platelet accumulation followed for 2 hours. Group A comprised untreated control animals, group B was treated with 17 ml saline/kg bw, and group C with 1 g dextran and 17 ml saline/kg bw (Macrodex).

Significant differences in platelet accumulation were observed only between the control and Macrodex groups at 105 and 120 minutes. In the control and saline groups four of eight vessels showed poor or no patency. All Macrodex vessels showed good patency. Control and saline vessels had large amounts of red thrombotic material, except for three saline cases with small amounts. After Macrodex treatment five of eight vessels were apparently clean, while the other three showed only small amounts of red thrombotic material.

Dextran seems not to influence platelet function but rather to inhibit fibrin stabilization and probably increases fibrinolysis. Vascular patency was only endangered by the formation of solid fibrin‐containing red thrombi.
Peripheral hemodynamic stability during prolonged anesthesia in the rat
Authors: Joos Karen M. , Blair William F. , Brown Thomas D. , Gabel Ronald H.
Published: March 2007

The present study tests the hypothesis that peripheal hemodynamics in the rat femoral artery remain relatively stable during 3 hours of general anesthesia. Hemodynamic variables (pulse period, maximal centerline velocity, lumen diameter, and mean volumetric flow) were measured by the 20 MHz‐pulsed ultrasonic Doppler velocimeter method at 30‐minute intervals. The hemodynamic variables were not statistically different during the duration of the study. The mean values were pulse period 160 ± 2 msec, maximal centerline velocity 37.0 ± 1.9 cm/sec, lumen diameter 0.94 ± 0.03 mm, and mean volumetric flow 1.92 ± 0.19 cc/min.
Modified great toe wrap for thumb reconstruction
Authors: Tsai Tsu‐min , Falconer David
Published: March 2007

Reconstruction of the traumatically amputated thumb can be achieved with good cosmetic and functional results utilizing autogenous bone graft and a neurosensory free wrap‐around flap from the great toe. The donor area of the toe is modified to create a wrap‐around flap to transfer innervated glabrous skin from the medial and lateral borders of the toe. This modification includes nail and nail matrix while preserving toe length and the important plantar weight‐bearing skin of the great toe. A series of three patients who have undergone thumb reconstruction utilizing this method are reported. Postoperative follow‐up averages 15 months. Sensory recovery is comparable to that reported in the literature; cosmetic appearance of the thumb and nail growth are good.
Free peroneal flap coverage of the great toe defect resulting from a wrap‐around flap transfer
Authors: Hashimoto Fumio , Nomura Susumu , Yamauchi Shigeki , Shimamura Kohji , Yoshimura Mitsuo
Published: March 2007

In thumb reconstruction, the wrap‐around free flap from the great toe with distal terminal phalanx attached gives a better replica of a thumb esthetically and functionally and has many advantages. However, there are problems in the great toe, such as delayed wound healing, pain caused by long‐time walking, ulceration, and skin erosion. We closed the skin defect of the great toe with a free peroneal flap in seven cases. In all cases of both the wraparound flap and peroneal flap complete healing was obtained after the operation without trouble. The donor great toe causes no significant morbidity.
Microsurgical extramucous ureteroureterostomy in rats
Authors: Lamesch Alfred J. , Dociu Nicolae
Published: March 2007

The purpose of this study was to perfect the microsurgical technique of ureteroureterostomy in rats as a contribution to reconstructive surgery of the urinary tract in congenital malformations in newborns and infants. Microsurgical ureteroureterostomy was performed in 100 rats with Nylon and Vicryl 10‐0 and 11‐0 swaged on a BV‐6 and BV‐8 needle. Postoperative investigation of renal function and permeability of the anastomoses was realized by macroscopic examination and by IM urography. The healing of the anastomoses was studied at different intervals after operation by histologic and scanning electron microscopic evaluation. Results include (1) per primam healing without stenosis in 98% of the cases; (2) urine proof anastomosis achieved to avoid scarification; (3) extramucous sutures preferable to prevent leakage and also crystallization that rapidly occurs in the rat and (4) tubing or nephrostomy is unnecessary.
Temporary arteriovenous shunt prior to free myoosseous flap transfer
Authors: Grenga Tad E. , Yetman Randall J.
Published: March 2007

The use of temporary arteriovenous shunt constructed in the lower extremity prior to a free microvascular transfer of an internal oblique/iliac crest flap, is described. The indications for the technique are presented. Conventional free flap transfer may require maturation of a suitable inflow source or outflow conduit, which is provided by a temporary shunt, subsequently used for recipient vessels. The two‐stage procedure is applicable when local vessels are inadequate for immediate transfer.
Determination of the patency of vascular prostheses implanted in the rat aorta by means of ultrasonic blood‐flow measurements
Authors: Hess F. , Steeghs S. , Jerusalem C. , Wijn P. , Skotnicki S.
Published: March 2007

Patency of vascular prostheses implanted in the rat aorta is usually confirmed by reoperation and inspection of the distal stump of the aorta for pulsations. Repeated reoperation on rats included in long‐term investigations is not possible because of the increasing formation of scar tissue and adhesions at the site of the distal aorta. Consequently, noninvasive ultrasonic Doppler measurement was investigated to determine whether this method could provide accurate information about the patency of an implanted prosthesis. A total of 37 rats with 10‐cm‐long prostheses implanted in the aorta (groups C nonsupported prostheses, n = 12; and D supported prostheses, n = 25), eight normal nonoperated controls (group A), and three rats with a ligated aorta (negative controls, group B) were studied over a period of 12 weeks. The Dopplerrecordings obtained in the normal animals served as controls for the recordings of rats with an implanted prosthesis. A prosthesis was considered patent if the Dopplermeasurements obtained from the femoral artery resembled that of the normal pattern. In seven cases a prosthesis was suspected to be occluded since the Dopplermeasurements resembled those obtained after aortic ligation. Autopsy confirmed the Dopplermeasurements in all cases. No Dopplermeasurements returned to normal in the femoral artery in the aorta‐ligated rats even after longer periods post‐operation. It is concluded that Dopplermeasurements can accurately provide information about the patency of a vascular prosthesis implanted in the rat aorta.
Per‐operative topical administration of ZK 36 374 (iloprost) acts favorably on patency of small artery anastomoses in rats
Authors: Kort Will J. , De Kam Janny , Westbroek Dick L.
Published: March 2007

Aspirin (group I, 20 mg/kg, 0.5 hour preoperatively, ip, xylocaine (group II, topical administation of 1 ml of a 2% solution), and ZK 36 374 (IIoprost) either pre‐ or per‐ or postoperatively (group III, 10 μg/kg 0.5 hour peroperatively iv; group IV, topical administration of 1 ml of a solution containing 25 μg/ml peroperatively; and group V, 10 μg/kg 0.5 hour postoperatively iv) were given to groups of BN female rats in order to improve the patency rate of small artery (<0.5 mm) anastomoses. The rats in group VI received saline peroperatively by topical application, this group served as a control. The patency was established by means of arteriography and macroscopical examination. Neither aspirin nor xylocaine improved the number of successful anastomoses. However, IIoprost administered topically, while performing the anastomosis, substantially improved the patency rate when compared with group VI, the control group. In the control group only five out of 21 animals showed patent anastomoses, whereas in group IV (IIoprost, topical administration) seven out of ten operations were successful.

The results suggest that IIoprost applied locally could be helpful in clinical microsurgery for elective operations as well as in replantation surgery.
An alternative technique of microvascular anastomosis
Authors: Hou Sheng‐Mou , Seaber Anthony V. , Urbaniak James R.
Published: March 2007

The femoral arteries and veins of rats were severed and reanastomosed, using either the conventional interrupted suture technique or an alternative interrupted technique that allows the lumen to remain visible throughout the reanastomosis procedure. The alternative technique involves placing the sutures in the posterior wall of the vessel, eliminating the necessity of rotating the microsurgical clamp during the anastomosis. Clinically, this method may be advantageous in cases where the anastomosis is being performed in a deep wound in which there is no room to turn over the microclamp. Additionally, this technique allows the posterior wall of the vessel to be observed throughout the anastomosis procedure, reducing the possibility of accidental placement of sutures through the posterior wall and resulting nonpatency. There was no significant difference between the two techniques in terms of operating time, patency rate, aneurysm formation, arteriography, and histological findings.
Experimental model for the study of the human appendix
Authors: Arnbjörnsson Einar
Published: March 2007

A simple and reproducible model for the experimental study of the normally functioning human appendix is described. The appendix removed from a human is transplanted into a nude mouse and is kept vital for at least 4 hours. This model is an improvement on previous models. It corresponds well with the working of the normal human appendix as regards tissue type and characteristics. Results are easily quantified and a paired control is possible in the experimental animal. This simplifies the experimental design and statistical calculations. The model can be used to gain additional information about the pathophysiology of the human appendix and the possible influence of drugs on this organ.
Nerve regeneration through a synthetic microporous tube (expanded polytetrafluoroethylene): Experimental study in the sciatic nerve of the rat
Authors: Cuadros C. Luis , Granatir Charles E.
Published: March 2007

Nerve grafts made of expanded polytetrafluoroethylene (PTFE) were used to bridge 10‐mm gaps in the sciatic nerves of rats. The most prominent gross and histological finding was abundant neovascularization and capillary ingrowth through the microporous PTFE wall. Organized, myelinated nerve tissue was observed. After 4 months, regeneration through hollow PTFE tubes (N = 16) was equivalent to autogenous nerve grafts (N = 12) as measured by gastrocnemius muscle weights (P = 0.33). Nerve conduction velocity in the hollow PTFE tubes was 21.7 m/sec as compared to 50.6 m/sec in the control nerves (P < 0.001).
Effects of lidocaine concentration on distal capillary blood flow in a rabbit ear model
Authors: Haines Peter C. , Ranzoni Joseph , Longnecker David E. , Morgan Raymond F.
Published: March 2007

The laser pulse doppler provides a noninvasive, reproducible method to measure the flux in distal capillary blood flow in a rabbit ear model. The distal capillary blood flow responds proportionally to changes in periarterial lidocaine concentration. The response is biphasic. Flow initially decreased from the baseline in all lidocaine concentrations between 0.5% and 10.0%. Proportional increases in distal blood flow above baseline are noted as the buffered lidocaine concentrations increase from 1.0% to 10.0%. Lidocaine concentration of 0.5% dose not increase distal blood flow above baseline.
Tubal reanastomosis: A comparison between microsurgical and microlaser techniques
Authors: McLaughlin David S. , Bonaventura Leo M. , Jarrett John C.
Published: March 2007

In order to evaluate the effect of the carbon dioxide laser as an adjunct to conventional microsurgical techniques, the authors retrospectively reviewed the charts of 53 patients who underwent tubal reanastomosis after elective sterilization. Thirty‐two patients had non‐laser microsurgical reanastomosis from 1981 to 1985; 21 patients had microlaser tubal reanastomosis from 1983 to 1985. All patients had unprotected intercourse for at least 1 year. In the non‐laser group, 15 were known to have conceived, and in the laser group, eight had conceived; success rates were 43.7% and 42.9%, respectively. It is concluded that the carbon dioxide laser's advantages (precision, hemostasis, and the ability to preserve more normal reproductive tissue), although technically beneficial in performing microsurgical tubal reanastomosis, may not prove to be superior to conventional microsurgical technique as pregnancy rates are compared. Additional long‐term studies are needed as more experience is gained to further delineate the role of the carbon dioxide laser for microsurgical tubal reanastomosis.
CO2 laser microsurgery: Five years experience with long‐term results
Authors: Mage G. , Pouly J. L. , Canis M. , Bruhat M. A.
Published: March 2007

Techniques and results of CO2 laser microsurgery are reported from a series of 123 patients operated on between 1979 and 1983. Salpingostomy was carried out in 76 patients, reversal of sterilization in 16 patients, reanastomosis for pathologic disease in 12 patients, and combined procedures in 19 patients. Results compare favorably with conventional microsurgery. CO2 laser surgery appears to be a very effective technique and is very easy to achieve in microsurgery. Correct use of CO2 laser is required in order to obtain a good post‐operative success rate. The surgeon must be competent in microsurgery and in laser technology.
Free vascularized fibular grafts in the treatment of congenital pseudarthrosis of the tibia
Authors: Minami Akio , Ogino Toshihiko , Sakuma Takashi , Usui Masamichi
Published: March 2007

Five patients with congential pseudarthorsis of the tibia treated by a free vascularized fibular graft are described. Follow‐up evaluation ranged from 15 to 81 months, with a mean of 40 months. Bony union was attained in three of five cases as determined roentgenographically. The remaining two cases failed to attain bony union. All cases except one, who was treated with a below‐knee amputation, subsequently attained bony union. However, four cases had five fractures after bony union. We discussed unsolved problems regarding the free vascularized fibular graft and fracture after bony union.
Sterilization reversals performed by fellows in training: What success rates can we reasonably expect?
Authors: Sauer Mark V. , Zeffer Kirsten B. , Bustillo Maria C. , Buster John E.
Published: March 2007

To assess outcomes of sterilization reversal procedures performed by fellows in training, we retrospectively analyzed 44 women who had undergone this procedure at a large teaching institution. All women studied had been followed postoperatively for a minimum of 12 months. Sixty‐five percent of patients became pregnant. Fifty‐four percent of patients successfully delivered a term infant. Compared to results tallied by experienced microsurgeons, no significant differences in outcomes were noted. We conclude that clinically inexperienced microsurgeons can obtain reasonable success rates for sterilization reversal procedures by carefully following established microsurgical principles.
Dual innervated index to thumb cross finger or island flap reconstruction
Authors: Hastings Hill
Published: March 2007

Partial volar amputations of the entire thumb pulp require soft tissue coverage that provides not only padding and protection for exposed bone and tendons, but also restoration of discriminative sensation. A modification of the radial sensory innervated cross finger flap from index to thumb is described, which includes separate reinnervation of the flap by repair of the dorsal sensory branch of the index radial digital nerve to the ulnar digital nerve of thumb. The anatomical basis for this flap is discussed and two example cases presented. Sensory reinnervation is rapid and does not require cortical reorientation.
Progression of the zone of injury in experimental nerve in juries
Authors: Zachary Lawrence S. , Dellon A. Lee
Published: March 2007

The extent of injury a nerve sustains after different mechanisms of injury is often difficult to determine at the time of injury. This study was designed to define the zone of injury for avulsed and transected nerves in an experimental animal model. We were able to demonstrate a progressive zone of injury in the avulsed nerves which would preclude primary neurorrhaphy while the zone of injury in a transected nerve tended to decrease during the three week period of observation.
Laser doppler bone probe in vascularized fibula transfers: A preliminary report
Authors: Schuurman Arnold H. , Bos Kurt E. , van Nus Yvonne H.
Published: March 2007

Continuous monitoring of circulation in bone transfers without a skin element may be possible with a laser doppler bone probe consistent with any free tissue transfer. Immediate reintervention is necessary when vascular insufficiency is suspected. In two clinical cases of vascularized fibula transfer, we were able to compare skin probe recordings with intraosseous probe recordings. There was no apparent difference in the recordings, suggesting that the bone probe alone may be useful for monitoring bone transfers and that it warrants further study.
Microvascular anastomosis in spontaneously hypertensive and stroke‐prone rats
Authors: Klara Peter M.
Published: March 2007

Carotid end‐to‐end microvascular anastomoses (MVA) were performed in 100 rats [50 spontaneously hypertensive (SHR); 30 spontaneously hypertensive stroke‐prone (SHR‐SP); and 20 normotensive controls (WKY)]. Animals were sacrificed at various intervals from immediately after anastomosis to 60 days after surgery, and vascular healing was studied with the sacnning electron microscope. In this manner vascular healing in normotensive rats (WKY) could be compared with that in hypertensive rats (SHR and SHR‐SP) with vascular disease. Results of this study suggest that vascular healing in hypertensive rats is delayed when compared with normotensive controls. Furthermore, suture material was occasionally incompletely endothelialized in hypertensive animals as long as 60 days after surgery and served as a potential source of emboli. Additionally, an increased susceptibility of hypertensive endothelium (SHR and SHR‐SP) to clamp and needle injury was apparent. In spite of this, there was a 100% patency rate of all anastomoses performed, indicating that patency, per se, is unaffected by hypertensive vasculopathy.
Experimental vascularized bone allografting
Authors: Randolph Mark A. , Yaremchuk Michael J. , Moore J. Russell , Robinson Robert A. , Weiland Andrew J.
Published: March 2007

Presented here is a compendium of studies investigating the fate of vascularized bone allografts. The first set of experiments employ the posterior rib graft in two canine models. The rib‐to‐mandible model was used to evaluate the rejection phenomena of vascularized bone allografts in an outbred dog model. This ascertained the time course of rejection and histological characteristics of the grafts. Immunosuppression of the graft recipients was attempted with azathioprine and cyclosporine. The results demonstrated that azathioprine was not an effective immunosuppressant, whereas cyclosporine resulted in survival of cortical osteons. The use of the vascularized rib allograft, with and without azathioprine, to bridge the defect in the dog femur was met with failure. Further studies employed a genetically defined rat model to determine the effect of different histocompatibilities on the survival of vascularized knee allografts. Grafts were transplanted from Lewis rats to syngeneic Lewis rats as isografts and to Fischer‐344 rats (F‐344) and Brown‐Norway rats (BN) as allografts. Grafts across a major histocompatibility barrier to BN were rejected by 7 days, whereas grafts across a weak histocompatibility barrier to F‐344 were rejected more slowly. The use of cyclosporine in this model abrogated the rejection response when administered to both groups continuously. However, a short course of cyclosporine was effective in preventing rejection in the F‐344 animals. Efforts to induce tolerance by blood transfusions, from the donor strain or from a third‐party donor, were not effective in preventing rejection.
Customized prefabricated neovascularized free flaps
Authors: Hirase Yuichi , Valauri Fredrick A. , Buncke Harry J. , Newlin Leonard Y.
Published: March 2007

Neovascularization of tissues into which a vascular pedicle has been implanted can result in the creation of a flap, or free flap, which is supported by those vessels as a neopedicle. This phenomenon allows the construction of customized prefabricated free flaps from tissue without restriction to naturally occurring vascular territories.
Parameters altering the success of the one‐anastomosis rat heart‐lung transplant
Authors: Scott Michael H. , D'Silva Milbhor , Gaarde William A. , Leisten James C. , Sadoff Joel A. , Axtelle Timothy S. , Hahn Gary S. , Plummer James M. , Chang Eil Sung , Lee Sun
Published: March 2007

The single‐anastomosis heart‐lung transplantation method in the rat developed by Lee and associates has been examined and has proven to be simple and reproducible. Technical procedures are discussed emphasizing those procedures that require special caution to ensure successful graft function. The donor and recipient rat strain combination has been found to influence the success of the transplantation procedure. Rat strain combinations used in our laboratories resulted in different percentages of donor heart survival. Using Lewis rat (RT11/1) recipients, 68% of Brown Norway rat (RT1 n/n) donor hearts and 97% of NBR rat (RT1 1/1) donor hearts survived. However, only 29% of Fischer rat (RT 1/1) donor hearts survived longer than 2 days when transplanted into Lewis rat recipients. In our laboratories, the Lee method of single‐anastomosis heart‐lung transplantation has been used successfully to evaluate whether immunoregulatory compounds alter heart allograft rejection.
Review of tissue welding applications in neurosurgery
Authors: Bailes Julian E. , Quigley Matthew R. , Cerullo Leonard J. , Kwaan Hau C.
Published: March 2007

New technical advances have made feasible the utilization of low‐powered laser energy for constructive applications. Experience with laser bonding of blood vessels, peripheral nerves, and dura has been obtained. These studies are summarized, and the future potential of laser bonding of tissues of the central nervous system is discussed.
A simple microretractor
Authors: Narayanan Krishna , Ramasastry Sai S.
Published: March 2007

The use of bulky retractors in experimental microsurgical procedures creates interference with the limited operative field. The current article describes a small but effective retractor made from ordinary staples, which are inexpensive and easily accessible.
The effects of intravenous prostacyclin in a model of microsurgical thrombosis
Authors: Bailes Julian E. , Quigley Matthew R. , Kwaan Hau C. , Nishiura Bing R. , Cerullo Leonard J. , Lastre Clara
Published: March 2007

Numerous agents have been administered in an attempt to achieve specific biochemical antiplatelet activity. A model of microsurgical trauma was utilized to create a nonocclusive thrombus, similar to what occurs in the postoperative period. Prostacyclin (PGI2) was given in a high intravenous dose which caused in vitro inhibition of platelet aggregation in rats and rabbits. Although hematological and cardiovascular side effects of PGI2 were tolerated, in vivo platelet thrombus formation persisted and constituted 25–75% of the postoperative thrombus. Even though platelets were inhibited by PGI2, other significant stimuli remained at the site of injury for activation and participation of platelets in the formation of a thrombus.
Effect of blood bonding on bursting strength of laser‐assisted microvascular anastomoses
Authors: Wang Su , Grubbs Philip E. , Basu Samir , Robertazzi Robert R. , Thomsen Sharon , Rose Daniel M. , Jacobowitz Israel J. , Cunningham Joseph N.
Published: March 2007

This experiment evaluated the influence of blood on the weld strength of laser‐assisted microvascular anastomoses (LAMA). Rat femoral arteries were anastomosed end‐to‐end by either direct laser welding (group I) or by a bloodbonded technique (group II) whereby fresh blood was applied to the vessel edges before laser exposure. Bursting strength was measured at 0, 1, and 24 hours and at 3 and 7 days by infusing methylene blue into the vessel while pressure was monitored. The results showed significantly increased bursting strength in group II compared with group I at 0 hour and 7 days (P < 0.05). There was a significant increase in bursting strength in group I from 0 hour to 1 hour (P < 0.05). It is concluded that blood‐bonding enhances the early bursting strength of LAMAs and may facilitate arterial wall healing.
An interposed superficial temporal artery graft bypass for anterior cerebral artery ischemia
Authors: Iwata Yoshikazu , Mizuta Tadahisa , Takemoto Osamu , Shimizu Keiji , Nakatani Susumu
Published: March 2007

A new microsurgical revascularization technique for anterior cerebral artery ischemia is reported. An arterial graft bypass interposed between the superficial temporal artery and the distal anterior cerebral artery was successfully completed in a 43‐year‐old male with transient ischemic attacks in the anterior cerebral artery territory. The contralateral superficial temporal artery was harvested and used as an arterial graft. Both procedures were carried out with one single transcoronal scalp incision. The patient's postoperative cerebral angiogram revealed good filling of the area distal to the stenotic lesion of the anterior cerebral artery through the bypass graft. The patient was discharged with no neurological deficit and has been free of ischemic events for more than 2 years since the surgery. If the bilateral superficial temporal arteries are fairly well developed, the ipsilateral superficial temporal artery can be used as an arterial graft for revascularization of the anterior cerebral artery territory.
An experimental flap model for the evaluation of intraarterial effects of drugs on skin viability
Authors: Parsa F. Don
Published: March 2007

An experimental flap model is presented utilizing the common laboratory rat. This flap allows the study of intraarterial infusion of pharmacological agents and their effect on the skin.
Rat surgery board
Authors: Boydell Cheryl L. , Rank William R. , Swartz William M.
Published: March 2007

Our microsurgery laboratory needed a number of surgical rat boards, and considering the expense of the ones already on the market, we decided to make our own. A 14 in × 10 in board was cut from a large Plexiglas® sheet. Suction cups with metal hooks were used to hold the rat in place. We found this board to be less expensive and also very versatile.
Recent microsurgical advances in China
Authors: Pan Yu‐Chuan , Lee W. P. Andrew
Published: March 2007

For more than two decades, microsurgery has been developed, practiced, and refined in China. For the most part, this has taken place independent of a parallel process in the Western World. Only until recent years has there been some communication from China regarding this microsurgical experience. The authors believe that there is much yet to be learned from the wealth of Chinese experience in microsurgery, just as Chinese surgeons have gained valuable information from the West. The authors reviewed the microsurgical literature in China from 1983 to 1986, and present here what we regard to be of particular interest to American microsurgeons, including the areas of digital reconstruction, replantation, flap transfer and transposition, and microsurgical techniques and patient management. Some historical background in the development of Chinese microsurgery is also provided.
Experimental microvascular autogenous vein grafts for arterial defects: II. A histopathologic study of the grafts
Authors: Fletcher Christopher D. M. , Kruavit Arthi , Mayou Brian , McKee Philip H.
Published: March 2007

Twelve autogenous vein grafts, of average diameter 1.5 mm, which had been used to bridge defects in the contralateral femoral artery of adult rabbits by a minimally traumatic technique, were examined over a 12‐week postoperative period. Each graft remained widely patent but showed fibroelastic intimal thickening with time. Further evidence of arterialisation was the development of a prominent subintimal layer of smooth muscle. Also noted was the presence of medial fibrosis, with both calcification and ossification. This latter is suggestive of damage due to disruption of the vasa vasorum. It would appear that arterialisation of microvascular vein grafts occurs independently of surgical trauma and is therefore difficult to avoid. However, these pathologic changes were not as severe, nor was there as much luminal narrowing, as at the previously described anastomotic sites. The most important cause of these changes appears to be arterial pressure.
Re‐endothelialization stages at the microvascular anastomosis
Authors: Isogai Noritaka , Kamiishi Hiroshi , Chichibu Shiko
Published: March 2007

After microsurgical suturing, the wound healing process at the rat femoral artery anastomosis was studied with scanning electron microscopy. The reendothelialization was divided into four successive stages, based on the development of a fibrin network and the rate of endothelial regrowth. Within 5 minutes of blood flow re‐establishment the fibrin network formation started to cover the wound surface; it was completed by the 3rd or 4th day. The endothelial recovery started on the 2nd day and continued to the base of the suture by the 6th day. Re‐endothelialization from the wound edge, which was formed between intact and injured endothelium toward the suture‐restrained site, was a two‐fold process: initially, a single endothelial film covered the anastomosis site, then, the singled endothelial sheet proliferated and thickened to complete the endothelialization. A better understanding of the stages involved in microvascular repair is beneficial in evaluating vascular recovery and its relationship to patency rates in microvascular surgery.
Wandering nerve graft technique for management of the recalcitrant painful neuroma in the hand: A case report
Authors: Mackinnon Susan E.
Published: March 2007

A new technique for the management of the painful neuroma following ray amputation of the index finger is reported. The rationale behind this operative procedure, which is based on both clinical and experimental work, is outlined. The patients' follow‐up to 4 years postoperatively is presented.
Axonal regeneration through peripheral nerve grafts: The effect of proximo‐distal orientation
Authors: Ansselin Annick D. , Davey David F.
Published: March 2007

Peripheral nerve transplants are used for the surgical repair of nerve loss. If normally orientated grafts contain branches, regenerating axons may be lost into them, limiting re‐innervation and restoration of function in the denervated area. Since axons entering a reversed graft may not be lost in this way, we have investigated whether reverse implantation could enhance the number of axons that reach the distal stump. In young adult rats, a section of sciatic nerve, including one major branch, was removed and reinserted with either the normal or reversed proximo‐distal orientation, using microsurgical techniques. After signs of recovery of function, the operated and contralateral unoperated nerves of each animal were fixed and processed for electron microscopy. Regenerated axons were seen to enter branches in normally orientated grafts, and there was substantial loss in the cross‐sectional area of the graft distal to the branch termination. Reverse grafts are as well reinnervated by regenerating axons as normally orientated grafts and show a smaller loss in the cross‐sectional area, even though the branches of these implants seemed to disappear.
Thin cutaneous flap for intra oral reconstruction: The dorsalis pedis free flap revisited
Authors: Banis Joseph C.
Published: March 2007

The dorsalis pedis flap provides thin, hairless tissue for a variety of intra oral defects. Due to concerns for the donor site, reconstructive surgeons have largely overlooked this flap, despite its numerous desirable qualities. The paper focuses on the anatomy of the first dorsal metatarsal artery and techniques which insure the preservation of adequate flap vascularity. The prevention of donor site complications centers around meticulous attention to the placement of skin grafts, with a secure tie‐over dressing and the use of a posterior splint. Patients are allowed to ambulate in the early postoperative period only when venous compression is provided with an ace bandage. Vigorous attention to detail on reconstructing the foot has minimized donor site complications. The dorsalis pedis flap continues to be an important method of reconstruction in our armamentarium of free tissue donor sites.
Mandibular reconstruction in the young adult using free vascularized iliac crest
Authors: Boyd J. Brian
Published: March 2007

Five young adults between the ages of 16 and 27 years underwent mandibular reconstruction with free vascularized iliac crest bone grafts based on the deep circumflex iliac artery. These were the only patients under age 30 years in a series of over 60 patients undergoing this procedure.

In all cases, the ipsilateral crest was employed, and special efforts were made to minimize bony bulk by removing the outer cortex and carefully shaping the graft. The bone graft underwent final trimming in situ, the exact dimensions being reproduced from measurements taken from the excised specimen.

When bone alone requires replacement, as in the majority of young patients, an excellent functional result can be anticipated. Occlusion can be maintained or even restored, and the normal facial contour can be re‐established. Osteointegrated implants hold out the possibility of providing full dental rehabilitation in an age group in which anything less is considered failure. Furthermore, the donor site scar can be hidden by a bathing suit.

It is concluded that this form of reconstruction is particularly suitable for the young adult, in whom cosmesis, function, donor site, and freedom from longterm complications are of supreme importance.
Postoperative monitoring of microsurgical free tissue transfers for head and neck reconstruction
Authors: Jones Neil Ford
Published: March 2007

Approximately 10% of free tissue transfers fail because of thrombosis of the arterial or venous anastomoses. Postoperative monitoring to allow early detection of impaired flap perfusion is crucial, especially in head and neck reconstruction, in which failure of a free flap may be associated with significant morbidity. Furthermore, the increasing use of “buried” free tissue transfers in the head and neck precludes direct clinical observation. The various techniques that have been advocated for clinical monitoring of free tissue transfers are reviewed, and their potential applications in head and neck reconstruction are discussed with specific emphasis on the use of lowfrequency continuous‐wave Doppler surface monitoring and implantable highfrequency pulsed ultrasonic Doppler monitoring.
Refined microneurovascular free muscle transplantation for reanimation of paralyzed face
Authors: Harii Kiyonori
Published: March 2007

Our first clinical success in microneurovascular free muscle transplantation for treatment of long‐standing facial paralysis was in 1973. The author introduces his recent technical refinements of this clinical procedure and the results obtained.
Neurolized nerve padding in actinic lesions: Omentum versus muscle use. An experimental study
Authors: Brunelli Giorgio A. , Brunelli Francesco , Di Rosa Fabio
Published: March 2007

Free microvascular greater omentum flap to pad brachial plexus after neurolysis for actinic lesions is a major operation. Thus several authors have suggested a simple padding by means of traditional muscle flaps. As contouring the brachial plexus elements is difficult using muscle, we wished to evaluate the formation of perineural fibrosis with either omentum or muscle, following neurolysis. An experimental model in rats was set up, dividing the two femoral nerves and wrapping one of them with the greater omentum and the other with abdominal muscles. The degree of perineural fibrosis at light microscopy observation was fivefold greater when muscle, rather than omentum, was used.
Emergency intracranial thromboendarterectomy for acute middle cerebral artery embolus
Authors: Opalak Michael E. , Chehrazi Bahram B. , Boggan James E.
Published: March 2007

Clinical application of microvascular techniques in emergency intracranial thromboembolectomy of middle cerebral artery bifurcation subsequent to angiography is presented. Blood flow was re‐established with 5–7 hours of the onset of the focal cerebral ischemic symptoms. Review of the literature supports a role for acute intracranial embolectomy in a selected group of patients in the absence of more effective medical therapy.
The venous flow augmentation pump: A solution to venous congestion
Authors: Lendvay Paul G. , Teston Leana M. , Maver Eric , Lyons Geoffrey
Published: March 2007

Venous congestion is a well‐recognized cause of failure of survival of replanted digits. When re‐exploration of a venous congested digit is not possible, an alternate solution is presented. A description of the venous flow augmentation pump is provided, along with a preliminary case report of its successful use.
A free flap system in sheep
Authors: Zoltie Nigel , Katsaros James , Tan Eugene
Published: March 2007

Five successful free flap transfers have been performed using the deep circumflex iliac artery system in sheep. The system is capable of providing cutaneous, myocutaneous, or osteomyocutaneous flaps, and details regarding these flaps are described.
Comparison of regeneration across a vascularized versus conventional nerve graft: Case report
Authors: Mackinnon Susan E. , Kelly Louise , Hunter Daniel A.
Published: March 2007

A histological and functional comparison of regeneration across a vascularized and conventional nerve graft was carried out in a clinical case. The two branches of the medial antebrachial cutaneous nerve were used to neurotize the median nerve at the wrist. The superficial branch of the radial nerve (vascularized nerve graft) and a conventional sural nerve graft were used as the interposition grafts between the two branches of the medial antebrachial cutaneous nerve and the median nerve. This nerve grafting procedure was carried out in two stages. The proximal neurorrhaphy was carried out 7 months prior to the distal nerve repair. Biopsies were taken from the distal portions of the vascularized radial sensory nerve and the conventional sural nerve at the time of the second procedure. Histological evaluation demonstrated superior regeneration across the vascularized nerve graft. Subjectively, the patient described better sensory recovery in the territory innervated by the vascularized nerve graft. Sensory testing in the two territories demonstrated better sensibility in the territory innervated by the vascularized nerve graft.