Abstract:
:Microvascular clamps have several potential shortcomings, including the risk of vessel injury. LeGoo, a novel reverse thermosensitive polymer (Pluromed Inc., Woburn, MA), is investigated as a substitute to vascular clamping in a microsurgical model and the technical details are described. Femoral vessels of Sprague Dawley rats were used to evaluate the usefulness of this polymer for performing end-to-end arterioarterial (AA), venovenous (VV), and end-to-side arteriovenous (AV) microvascular anastomoses. The ability to obtain and maintain hemostasis was assessed. Secondary endpoints, including polymer volume, concentration, temperature, infusion technique, ability to reinfuse, blood vessel stenting effect, polymer dissolution characteristics, and reestablishment of flow, were also noted. Initial hemostasis occurred in every case. Mean duration of efficacy (hemostasis) after initial injection was 17.8 minutes (4 minutes to 44.5 minutes) for AA anastomoses and 31.8 minutes (13 minutes to 46 minutes) for VV anastomoses. Mean volume of polymer initially injected was 0.11 mL (0.01 mL to 0.20 mL) and 0.07 mL (0.06 mL to 0.10 mL) for AA and AV arteries, respectively, and 0.14 mL (0.10 mL to 0.20 mL) and 0.20 mL (0.15 mL to 0.27 mL) for VV and AV veins. Use of LeGoo in veins was clearly superior to arterial use with regard to the technical aspects of injecting LeGoo and reestablishing hemostasis, as well as greater vessel stenting effect and less vessel retraction. This novel polymer showed promise for its ability to allow for hemostasis while performing microvascular anastomoses. Improvements were made with regard to injection techniques, appropriate volumes, ability to reliably determine gel plug dissolution, and final vessel patency. Preliminary results demonstrate that this polymer may be a viable substitute for microvascular clamps.
journal_name
J Reconstr Microsurgjournal_title
Journal of reconstructive microsurgeryauthors
Manchio JV,Litchfield CR,Zeheb R,Bryan DJdoi
10.1055/s-0028-1104556subject
Has Abstractpub_date
2009-01-01 00:00:00pages
69-76issue
1eissn
0743-684Xissn
1098-8947journal_volume
25pub_type
杂志文章abstract::This is the first in a series of studies designed to investigate the simultaneous changes in blood flow and microcirculation in an island flap during ischemia, in an ischemia-reperfusion model in the rabbit. An island groin flap based on the inferior epigastric vessels was harvested in 17 rabbits. The flap was rendere...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006414
更新日期:1997-07-01 00:00:00
abstract::Five cases of chronic ulceration following skin graft resurfacing of the weight bearing surface of the heel are presented. All were managed with debridement and coverage with a free innervated dorsalis pedis tissue transfer. The technical refinements that have contributed to the reliability of the flap include careful...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007075
更新日期:1985-01-01 00:00:00
abstract::Multiple level amputation has been described as a contraindication to replantation. This is a case report of a patient with a double level amputation through the palm and forearm that was successfully replanted. Because of the need for multiple stages of reconstructive surgery, it was not clear until the end result th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1007016
更新日期:1986-04-01 00:00:00
abstract::The ultrastructure of the early regenerative response in an end-to-side neurorrhaphy rat model was studied using transmission electron microscopy. The ipsilateral saphenous nerve was grafted to the sciatic nerve under the following conditions: Group 1, the epineurium and perineurium of the sciatic nerve remained intac...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2000-7339
更新日期:2000-05-01 00:00:00
abstract::In microsurgical arterial anastomoses, there are some occasions in which the diameter of the distal artery is much larger than that of the proximal one. A fish-mouth incision technique is useful when there is considerable size discrepancy. However, this method cannot be used when the distal artery is much larger than ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006576
更新日期:1994-03-01 00:00:00
abstract::Patients undergoing free tissue transfer are particularly susceptible to hypothermia. The goal was to investigate the impact of intraoperative core body temperature on free flap thrombosis. Two hundred twelve cases of free flap reconstruction at Yale-New Haven Hospital between 1992 and 2008 were reviewed. Free flap th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0030-1268211
更新日期:2011-02-01 00:00:00
abstract::Microvascular techniques are important in making routine anastomoses quicker and difficult anastomoses easier. The authors have developed three types of sleeve anastomoses for different size vessels: a three-stitch sleeve anastomosis, four-stitch sleeve anastomosis, and sidecut sleeve anastomosis. Arteriography, in vi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006561
更新日期:1995-11-01 00:00:00
abstract::In a comparative study, it was demonstrated that sutureless, laser-welded, end-to-end anastomoses in the rat femoral artery and vein are feasible, using either CO2 or Nd:YAG laser. Conventional microsurgical suture anastomoses served as the controls. Patency rates in experimental animals and controls were equal (96 to...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006647
更新日期:1993-05-01 00:00:00
abstract::Nerve transection using rat sciatic nerves was employed to observe morphologic changes in the periodic denervation of Pacinian corpuscles. During periods of from 1 to 20 weeks after surgery, a total of 15 corpuscles were obtained under the operating microscope and processed for morphologic analysis using light and ele...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000101
更新日期:1999-05-01 00:00:00
abstract::A modified, two-stage arteriovenous flow-through venous flap was designed to repair skin defects due to third-degree burns on the dorsum of the hand in four patients. Two weeks after plasty of an arteriovenous (A-V) shunt between the greater saphenous vein and dorsalis pedis artery, the arterialized flow-through venou...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006429
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Reverse homodigital dorsoradial (RHD) flap has been developed to repair soft-tissue defects of the thumb. However, few articles have reported this flap with long-term follow-up. This retrospective study was designed to evaluate the RHD flap and investigate factors affecting sensory recovery. METHODS:From Fe...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0035-1548743
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to identify whether intraoperative use of vasoactive medications increases the risk of free flap failure or complications through a systematic review and meta-analysis. MATERIALS AND METHODS:PubMed/MEDLINE, EMBASE, and Scopus databases were searched for studies published through...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0035-1563381
更新日期:2016-02-01 00:00:00
abstract::A transverse rectus abdominis musculocutaneous free flap was electively performed for reconstructing the cutaneous cover in a patient during the early puerperium (12 hr after delivery). This flap was chosen because of the natural expansion achieved by pregnancy, and because it would cover the entire area to be reconst...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006478
更新日期:1996-05-01 00:00:00
abstract::Eleven patients with paralysis of muscle groups in the upper or lower extremity were clinically diagnosed after previous proximal direct trauma to the corresponding peripheral nerves, without complete nerve disruption. Patients were seen within an average of 8 months after trauma (minimum 3 months and maximum 2 years ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1000087
更新日期:1999-04-01 00:00:00
abstract::Small fiber pathology is a common clinical entity with a variable clinical presentation and etiology. Unfortunately, little has been described regarding its treatment because a majority of cases are idiopathic. Hence, treatment often consists of symptomatic management of pain and autonomic dysfunction. This report des...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0033-1349756
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:The authors presented their clinical experience and demonstrated surgical methods for reconstructing complex bone and soft tissue defects of the hand by using modified chimeric radial collateral artery perforator flaps. METHODS:Surgical procedures that employed 16 modified chimeric radial collateral artery ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0034-1390324
更新日期:2015-03-01 00:00:00
abstract::The use of growth factors in inducing angiogenesis and enhancing flap viability has provided promising results. Targeted gene therapy has evolved in hopes of increasing the longevity and effectiveness of these growth factor treatments. The purpose of this study was to examine the effect of preoperative treatment by va...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2005-915207
更新日期:2005-08-01 00:00:00
abstract::A seven-year-old-boy received a digit replantation after 26 hours of warm ischemia and showed good recovery of motor and sensory functions. In the case reported, replantation was performed after a much longer ischemic time than had been considered an indication for the procedure in previous reports. Successful replant...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006977
更新日期:1987-01-01 00:00:00
abstract::Radical resection of tongue and oropharyngeal carcinomas often results in complex defects that are challenging to reconstruct. Furthermore, remaining function should not be disturbed by the reconstruction. We introduce a new flap design and monitored swallowing and speech following reconstruction of complex oral defec...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2008-1078691
更新日期:2008-04-01 00:00:00
abstract::The enhancement of blood flow in experimental skin flaps following postischemic perfusion washout was investigated in rats. Unilateral island skin flaps based on the superficial epigastric vessels were raised and subjected to 6 hr of primary ischemia. Group 1 was designated as a control and did not undergo postischemi...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006753
更新日期:1993-11-01 00:00:00
abstract::The reconstruction of the flexor tendon in zones I and II of a ring finger in a single stage, using a free vascularized tendon graft, is reported in a single clinical case. The flexor digitorum superficialis (FDS) tendon of the same finger was freely transferred based on a vascular branch off the ulnar vessels. The ul...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2006-931905
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND: The volume of the profunda femoris artery perforator (PAP) flap limits its indications to small- and medium-sized breast reconstructions after modified radical mastectomy for cancer. We report a modified PAP flap design, including not only a vertical extension that increases its volume but also the skin sur...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-0038-1649508
更新日期:2019-01-01 00:00:00
abstract::The use of nerve conduits has evolved from a previous experimental idea to a clinical reality over the last ten years. An overview of the literature on the clinical use of nerve conduits in peripheral-nerve repair is presented. ...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章,评审
doi:10.1055/s-2002-19889
更新日期:2002-02-01 00:00:00
abstract::The use of interposition vein grafts has been associated in the literature with a high complication and flap failure rate. Ninety-three vein grafts in 55 patients over a 46-month period were analyzed to evaluate the clinical reliability of vein grafts in a predominantly trauma patient population (37/55). Fifty-two art...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006446
更新日期:1996-01-01 00:00:00
abstract::Multilayered tubes fabricated from human amnion were placed subcutaneously and/or longitudinally in contact with an axial artery and vein in rats. Histologic evaluation at the third postoperative week showed that the tubes had incorporated with the surrounding fibrovascular tissue. New capillary formation within the t...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006749
更新日期:1993-11-01 00:00:00
abstract::The authors' experience indicates that good functional results are achievable in cases with wide resection of the knee extensor mechanism. They report a low-grade myxoid fibrosarcoma patient in whom a one-stage functional reconstruction was carried out by transfer of a free latissimus dorsi flap without secondary surg...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2005-871749
更新日期:2005-05-01 00:00:00
abstract::This experimental study correlated varying methods of nerve repair with the degree of functional return using the rat sciatic nerve as a model. Six groups of adult male Sprague-Dawley rats (300 to 350 g) had their left sciatic nerve crushed (Group 1), transected and not repaired (Group 6), or transected and repaired u...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006804
更新日期:1990-01-01 00:00:00
abstract::The time course of revascularization of grafted nerves, and the possible dependence of this revascularization on the length of the graft are two related questions that are addressed. Survival of Schwann cells in the nerve graft and a timely revascularization must be seen as a precondition for an optimal regeneration p...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006938
更新日期:1988-07-01 00:00:00
abstract::In the present study, the authors reevaluated the temporal course and properties of neurotrophic activities present in the fluid accumulating in the silicone-chamber model for nerve regeneration. The fluid collected from silicone chambers was tested in four different dissociated neuronal cell cultures. Furthermore, th...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006537
更新日期:1995-05-01 00:00:00
abstract::Vascularized bone allografts (VBAs) could be useful adjuncts to the clinical reconstructive surgeon's arsenal. These grafts are known experimentally to be subject to host rejection. One way to control the rejection problem would be to develop specific immune unresponsiveness via host conditioning. Using a proven relia...
journal_title:Journal of reconstructive microsurgery
pub_type: 杂志文章
doi:10.1055/s-2007-1006992
更新日期:1987-04-01 00:00:00