Abstract:
BACKGROUND:: Technical problems at the site of the anastomosis compromise an underappreciated proportion of microsurgical free tissue transfers. Intraoperative identification of technical errors may be able to prevent reexploration surgery and early flap failure. We report the first human study on a new microscope-integrated fluorescence angiography technique, which allows for intraoperative imaging of the anastomotic site. METHODS:: Fifty consecutive patients undergoing reconstructive microsurgical procedures were enrolled in the study. Intraoperative near infrared indocyanine green videoangiography (ICGA) was performed on all microsurgical anastomoses, after they had been assessed by the operating surgeon by conventional clinical patency tests. Anastomoses deemed to be occluded by the ICG-angiography were intraoperatively revised, and the result of revision was compared with angiographic findings. RESULTS:: In 11/50 (22%) of patients, where the surgeon had classified the anastomoses as patent, microangiography identified a total luminal occlusion (six) and/or significant alterations in blood flow (five), potentially predisposing toward postoperative flap failure. Intraoperative revision confirmed angiographic findings in 100% of cases, and was always associated with flap survival. The decision not to revise despite anastomotic occlusion by the intraoperative angiogram was always followed by flap loss or early reexploration. A delayed return of venous blood from the flap predisposed toward postoperative flap failure. CONCLUSIONS:: Hand-sewn anastomoses are subject to technical errors, and conventional patency tests have a low sensitivity for revealing anastomotic failure. Microscope integrated microangiography is an excellent method for identifying significant anastomotic problems, which would have otherwise gone unnoticed. The potential impact on early flap failure and reexploration surgery is considerable. (c) 2009 Wiley-Liss, Inc. Microsurgery 2009.
journal_name
Microsurgeryjournal_title
Microsurgeryauthors
Holm C,Mayr M,Höfter E,Dornseifer U,Ninkovic Mdoi
10.1002/micr.20645subject
Has Abstractpub_date
2009-01-01 00:00:00pages
509-14issue
7eissn
0738-1085issn
1098-2752journal_volume
29pub_type
杂志文章相关文献
MICROSURGERY文献大全abstract:INTRODUCTION:The profunda artery perforator (PAP) flap is a new addition to our reconstructive armamentarium. In effort to better understand patient candidacy for the PAP flap we characterized the profunda artery perforators on preoperative imaging. METHODS:A retrospective review was completed of 40 preoperative poste...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.21980
更新日期:2012-10-01 00:00:00
abstract::This investigation quantitatively compared lumenal dimensions of 1 mm end-to-side anastomoses with longitudinal or transverse arteriotomies into host arteries 1.5-2 mm in diameter. In 27 rats, 6-7 mm sections of iliac arteries (1 mm in diameter) were sutured as small bypasses onto abdominal aortae (1.5-2 mm in diamete...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1920110206
更新日期:1990-01-01 00:00:00
abstract::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 denervate...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1920070302
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:In a vessel-depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of ...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.30259
更新日期:2018-09-01 00:00:00
abstract::Preoperative chemoradiation therapy increases the risk of pharyngocutaneous fistula (PCF) after laryngectomy. In this report, we describe the use of a free jejunal patch flap and a deltopectoral flap for surgical treatment of a large PCF. A 52-year-old man underwent salvage laryngectomy and right neck dissection after...
journal_title:Microsurgery
pub_type:
doi:10.1002/micr.22464
更新日期:2017-01-01 00:00:00
abstract::The aim of this study was to determine whether the administration of free radical antagonists, immediately before and during the early minutes of reperfusion, improves muscle survival 24 hr after a period of ischemia. Rabbit rectus femoris muscles were isolated, made ischemic for 3 1/2 hr and treated with either desfe...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/(SICI)1098-2752(1996)17:9<517::AID-MICR7>3
更新日期:1996-01-01 00:00:00
abstract::Heart and spleen twin grafts from LEW to ACI rats may survive permanently, whereas those grafted from ACI to LEW rats do not. This strain difference in graft acceptance was analyzed quantitatively by transplanting one to three ACI spleens into LEW rats in order to compensate for the relatively small size of ACI spleen...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1920040407
更新日期:1983-01-01 00:00:00
abstract::Isolated penile lymphedema is a rare but severely disabling condition due to reduced lymphatic drainage. In this area treatment opportunities are poor being that conservative management is usually not effective and surgery limited to debulking lymphangiectomy, which is indicated only in very severe cases. Lymphovenous...
journal_title:Microsurgery
pub_type:
doi:10.1002/micr.30560
更新日期:2020-09-01 00:00:00
abstract::Consecutive or simultaneous contralateral breast reduction is a frequent request from patients undergoing unilateral breast reconstruction. Both procedures can be combined using otherwise discarded tissue as a split breast graft for reconstruction of the contralateral side. There have been few reports on the use of pe...
journal_title:Microsurgery
pub_type:
doi:10.1002/micr.30654
更新日期:2020-09-19 00:00:00
abstract:BACKGROUND:Thrombosis is a common cause of flap failure in microvascular tissue transfer, which questions the effects of anemia on this outcome. This article seeks to contribute a large, multi-institutional data analysis to this debate. METHODS:Free tissue transfer patients were identified in the National Surgical Qua...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.22107
更新日期:2013-09-01 00:00:00
abstract::We present the case of a 22-year-old woman with an aneurysmal cyst of the right proximal radius, treated by resection and a free bone graft (microvascular fibular transfer), without recurrence after 4 years. Over a 4 month period, there was a rapidly expanding and lytic lesion found in the radius. There were symptoms ...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1920140413
更新日期:1993-01-01 00:00:00
abstract:INTRODUCTION:Lymphedema is a chronic condition caused by the obstruction or impairment of lymphatic fluid transport resulting in irreversible skin fibrosis. Besides conservative therapy, surgical techniques for lymphedema including liposuction, lymphatico-lymphatic bypass, lymphovenous anastomosis (LVA), and vasculariz...
journal_title:Microsurgery
pub_type: 杂志文章,评审
doi:10.1002/micr.30246
更新日期:2017-11-01 00:00:00
abstract::An experimental model was developed for continuous measurement of the common carotid blood flow, in the anesthetized rat, with an electromagnetic flowmeter. The mean carotid blood flow for 41 rats averaged 3.2 +/- 0.2 ml/min at an average mean arterial pressure of 101 +/- 2.5 mm Hg and arterial pO2 of 106 +/- 3.4 mm H...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1920130513
更新日期:1992-01-01 00:00:00
abstract::There are controversial in vitro data comparing the strength of the cellular immune response between allogeneic and xenogeneic stimulator/responder combinations. The present study therefore compares in vivo lymphocyte proliferation using heart transplantation (HTx) models in mice. Heterotopic HTx into BALB/c mice was ...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.10183
更新日期:2003-01-01 00:00:00
abstract::Vascularized grafting with segments of fibula was performed in four men with aseptic necrosis of the femoral head. The patients were restricted to relatively young individuals in whom the necrosis seemed to be confined to two-thirds or less of the femoral head and in whom the outer shell of the femoral head appeared r...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1920040108
更新日期:1983-01-01 00:00:00
abstract::Authors report over 30 years of their own clinical experience in the treatment of chronic peripheral lymphedemas by microsurgical techniques performed at the Center of Lymphatic Surgery of the University of Genoa, Italy. Over 1,500 lymphedema patients were treated with microsurgical techniques. Derivative lymphatic-ve...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.20346
更新日期:2007-01-01 00:00:00
abstract::This study entailed direct stereomicroscopic observations of rat abdominal island flaps and the sequence of vascular events that occurred during and after occlusion by clamping of the individual femoral vessels for varying time intervals of up to 16 hours. The vascular changes and the status of the circulation in the ...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1920040205
更新日期:1983-01-01 00:00:00
abstract::In this retrospective study, the survival rates of fingertip replantation with and without vein grafting were evaluated along with their postoperative functional and cosmetic results. One hundred twenty-one-fingertip amputations were performed in 103 patients between September 2002 and July 2007. Thirty-four amputated...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.20614
更新日期:2009-01-01 00:00:00
abstract::This study recognizes recent advances in the understanding of the anatomy and physiology of peripheral nerves at the cellular level. It has reproduced study conditions originally advocated by de Medinaceli and coworkers, with modifications. Eighty-four rats were divided into three groups. Group A underwent sciatic ner...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1920100408
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Venous complications have been reported as the more frequently encountered vascular complications seen in the transfer of deep inferior epigastric artery (DIEA) perforator (DIEP) flaps, with a variety of techniques described for augmenting the venous drainage of these flaps to minimize venous congestion. The...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.20712
更新日期:2010-01-01 00:00:00
abstract::The purpose of this experiment was to determine the stimulating and recording characters of fascicular physioelectrical signals in the activity of peripheral nerves by longitudinally implanted intrafascicular electrodes (LIFEs) in a rabbit sciatic nerve model, and discuss the future application of LIFEs in functional ...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.10116
更新日期:2003-01-01 00:00:00
abstract::Monoclonal antibody directed against CD40 ligand prevents acute allograft rejection in several models of solid-organ transplantation. This study describes the use of CD40 ligand as antirejection therapy in a mouse peripheral nerve allograft model. C3H mice received 8-mm nerve isografts (n = 2) or nerve allografts from...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.20028
更新日期:2004-01-01 00:00:00
abstract::The purpose of this study was to evaluate the effect of wrapping bioabsorbable nerve conduit around primary suture repair on motor nerve regeneration in a rat model. Forty rats were randomly divided into two experimental groups according to the type of repair of the rat sciatic nerve: group I had primary suture repair...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.22274
更新日期:2014-10-01 00:00:00
abstract::The groin flap is one of the most usable flaps. It provides a large amount of skin coverage with an easily concealed donor site. However, when the flap is used to reconstruct areas of the neck, hand, or foot, a secondary procedure for defatting is usually necessary. Thinner flaps are thought to be more useful in these...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/(SICI)1098-2752(1996)17:1<41::AID-MICR8>3.
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:The proximal peroneal artery perforator (PPAP) flap is a reliable, thin fasciocutaneous flap. The purpose of this article was to report our experience with the use of free PPAP flaps for reconstruction of defects of the distal hand and foot. PATIENTS AND METHODS:From November 2012 to September 2013, 9 patie...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.22364
更新日期:2016-03-01 00:00:00
abstract::We used the rat medial gastrocnemius free flap, based on a pedicle of the femoral artery and vein, in order to test the tolerance of skeletal muscle to cold ischemia-reperfusion (IR) injury, and to determine whether tolerance can be enhanced by pre-ischemic perfusion with tissue/organ preservation solutions. Muscle fl...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/1098-2752(2000)20:7<343::aid-micr6>3.0.co;
更新日期:2000-01-01 00:00:00
abstract::Orthotopic partial liver transplantation (PLT) models were developed in rats to explore the unique role of the liver in transplant tolerance. In PVG rats, syngeneic PLT established that surgical reduction to one-third of the liver and orthotopic transplantation permitted survival. Allogeneic PLT in the PVG to DA liver...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1036
更新日期:2001-01-01 00:00:00
abstract:AIM:The clinical value of adipofascial flaps based on distal ulnar or radial-artery perforators is demonstrated in a series of 14 patients with severe hand injuries and significant soft tissue defects requiring coverage. MATERIAL AND METHODS:There were 10 male and 4 female patients, aged between 23 and 72 years. The d...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.20374
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:The medial thigh is a well-hidden area. The two most common flaps from this area are the transverse upper gracilis (TUG) and profunda artery perforator (PAP) flaps. Herein, we explored the applications of combined TUGPAP flap to reconstruct large and complex defects in different regions. METHODS:Between Nov...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.30413
更新日期:2019-05-01 00:00:00
abstract::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 histologi...
journal_title:Microsurgery
pub_type: 杂志文章
doi:10.1002/micr.1920070207
更新日期:1986-01-01 00:00:00