Another method to prevent venous thrombosis in microsurgery: an in situ venous catheter.

Abstract:

:Free-flap failure is in the order of 4 to 10 percent. Heparin is more effective at preventing venous thrombosis than arterial thrombosis. This study was undertaken to investigate the efficacy of delivering heparin at a high dose locally but low dose systemically (heparin infusion via a catheter placed proximal to the venous anastomosis) to prevent venous thrombosis in microsurgery. A model of venous thrombosis was first established by a venous inversion graft in the rat femoral vein (this was performed in seven animals and resulted in 100 percent thrombosis). Saline and heparin were delivered proximal to the inverted vein graft to assess the effect of each in preventing venous thrombosis. Flow/patency distal to the inverted vein graft was assessed by observation under the microscope, the milk test, and rate of flow (flowmeter). Saline infused via a catheter proximal to the venous inversion graft resulted in 100 percent thrombosis in 10 animals. Heparin (100 U/ml at 2 to 3 ml/hour) infused through a catheter for 2 hours proximal to the anastomosis resulted in flow in all 10 animals during the infusion. Blood was also taken before beginning the procedure (control) and after the heparin infusion distal to the anastomosis (local partial thromboplastin time) as well as in the contralateral femoral vein (systemic). The control for all animals that received heparin was <3 minutes. The systemic partial thromboplastin time after heparin infusion was <3 minutes in seven animals, 3.3 minutes in two animals, and >7 minutes in one animal. The local partial thromboplastin time distal to the inverted vein graft was >10 minutes in nine animals and 3.7 minutes in one animal. The study also had a clinical component, in which a catheter was placed in a vein of the free flap, and heparin was infused over 5 days. This technique has been used in 83 consecutive free flaps. In three recent free flaps performed on the limbs, the local partial thromboplastin time (close to the anastomosis) was raised but the systemic time was normal. This technique offers a method in preventing venous thrombosis in microsurgery. It is simple to implement and is not associated with the systemic complications of heparin.

journal_name

Plast Reconstr Surg

authors

Hudson DA,Engelbrecht G,Duminy FJ

doi

10.1097/00006534-200003000-00024

subject

Has Abstract

pub_date

2000-03-01 00:00:00

pages

999-1003

issue

3

eissn

0032-1052

issn

1529-4242

journal_volume

105

pub_type

杂志文章
  • Interventions to Decrease Postoperative Edema and Ecchymosis after Rhinoplasty: A Systematic Review of the Literature.

    abstract:BACKGROUND:Today, minimally invasive procedures are becoming more popular because of the fast recovery. Rhinoplasty is a common facial plastic surgery procedure that can be associated with significant postoperative morbidities, especially periorbital edema and ecchymosis. The aim of this review is to summarize the resu...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000002101

    authors: Ong AA,Farhood Z,Kyle AR,Patel KG

    更新日期:2016-05-01 00:00:00

  • A nationwide curriculum analysis of integrated plastic surgery training: is training standardized?

    abstract:BACKGROUND:The integrated model of plastic surgery education, shortly to become the standard for all 6-year programs, has set minimal but no maximal exposure to plastic surgery. The authors hypothesized that the first 3 years of integrated training will show variability among residency programs. METHODS:Rotation sched...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3182a8089c

    authors: Schneider LF,Barr J,Saadeh PB

    更新日期:2013-12-01 00:00:00

  • Spinal cord stimulation improves survival in ischemic skin flaps: an experimental study of the possible mediation by calcitonin gene-related peptide.

    abstract::Currently, spinal cord stimulation is used to treat ischemia and ischemic pain, with the best results observed in vasospastic cases. It was earlier demonstrated that spinal cord stimulation may attenuate experimentally induced vasospasm in an island flap in the rat. The present study was designed to investigate whethe...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199904040-00018

    authors: Gherardini G,Lundeberg T,Cui JG,Eriksson SV,Trubek S,Linderoth B

    更新日期:1999-04-01 00:00:00

  • Analysis of fiber type transformation and histology in chronic electrically stimulated canine rectus abdominis muscle island-flap stomal sphincters.

    abstract::Dynamic skeletal muscle flaps are designed to perform a specific functional task through contraction and relaxation of their muscle fibers. The most commonly used dynamic skeletal flaps today are for cardiomyoplasty and anal or urinary myoplasty. Low-frequency chronic stimulation of these flaps enables them to use the...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.PRS.0000034921.49695.3D

    authors: Majzoub RK,Bardoel JW,Maldonado C,Barker JH,Stadelmann WK

    更新日期:2003-01-01 00:00:00

  • A simple reconstruction for congenital unilateral lower lip palsy.

    abstract:BACKGROUND:Congenital unilateral lower lip palsy or congenital hypoplasia of the depressor anguli oris muscle, also known as asymmetric crying facies, characterized by deformity of the lower lip, lacks aggressive surgical intervention methods. Although several dynamic and static reconstruction methods have been reporte...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000264062.64251.10

    authors: Udagawa A,Arikawa K,Shimizu S,Suzuki H,Matsumoto H,Yoshimoto S,Ichinose M

    更新日期:2007-07-01 00:00:00

  • Penile Inversion Vaginoplasty with or without Additional Full-Thickness Skin Graft: To Graft or Not to Graft?

    abstract:BACKGROUND:Penile inversion vaginoplasty is considered to be the gold standard for gender reassignment surgery in transgender women. The use of additional full-thickness skin graft as neovaginal lining is controversial. Some believe that having extra penile skin for the vulva gives better aesthetic results. Others beli...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000003108

    authors: Buncamper ME,van der Sluis WB,de Vries M,Witte BI,Bouman MB,Mullender MG

    更新日期:2017-03-01 00:00:00

  • Use of the AO plate for immediate mandibular reconstruction in cancer patients.

    abstract::Free vascularized bone grafts have revolutionized mandibular reconstruction, yet their use in all mandibulectomy patients is not always necessary. A recently developed alternative to bony reconstruction has been the use of the AO reconstruction plate. We compared the use of the AO reconstruction plate with immediate f...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199110000-00005

    authors: Schusterman MA,Reece GP,Kroll SS,Weldon ME

    更新日期:1991-10-01 00:00:00

  • Treatment of total sternal necrosis using the latissimus dorsi muscle flap.

    abstract::Complications after a median sternotomy incision, which is used currently in most cardiac and mediastinal surgical procedures, although infrequent, are serious. If sternal dehiscence follows median sternotomy, infection extends to vital underlying structures, exposing the anterior part of the heart and ascending aorta...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198511000-00008

    authors: Tizian C,Borst HG,Berger A

    更新日期:1985-11-01 00:00:00

  • Quadrilateral space syndrome: diagnosis and operative decompression technique.

    abstract::We present a series of five patients with quadrilateral space syndrome. All patients had the diagnosis made on the basis of (1) tenderness over the quadrilateral space, (2) paresthesia over the lateral shoulder and upper posterior arm, and (3) deltoid weakness associated with decreased shoulder abduction. A history of...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199105000-00016

    authors: Francel TJ,Dellon AL,Campbell JN

    更新日期:1991-05-01 00:00:00

  • Surgical correction of cryptotia with superiorly based superficial mastoid fascia and skin paddle.

    abstract::An approach for the correction of cryptotia using a superiorly based superficial mastoid fascial flap and a skin paddle is introduced. The buried portion of the auricle was exposed through an incision made along the upper part of the helix, followed by an appropriate correction of the deformed cartilage. Protrusion of...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200003000-00002

    authors: Yoshimura K,Ouchi K,Wakita S,Uda K,Harii K

    更新日期:2000-03-01 00:00:00

  • Effects of Extracorporeal Shock Wave Therapy on Distraction Osteogenesis in Rat Mandible.

    abstract:BACKGROUND:Distraction osteogenesis has widespread clinical use in the treatment of congenital and acquired craniofacial deformities. Nonetheless, during the prolonged consolidation period, the newly regenerated bone carries the risk of complications. A known method for enhancing bone healing is extracorporeal shock wa...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000004980

    authors: Ginini JG,Maor G,Emodi O,Shilo D,Gabet Y,Aizenbud D,Rachmiel A

    更新日期:2018-12-01 00:00:00

  • Analysis of nerve and neuropeptide patterns in vacuum-assisted closure-treated diabetic murine wounds.

    abstract:BACKGROUND:Reestablishment of the peripheral nervous system occurs in parallel with wound healing. With accelerated wound healing seen with the vacuum-assisted closure device, the authors studied its effects on nerve fiber regeneration, nerve sprouting, and the stimulation of neuropeptides and neurotrophins. METHODS:A...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181da86d0

    authors: Younan G,Ogawa R,Ramirez M,Helm D,Dastouri P,Orgill DP

    更新日期:2010-07-01 00:00:00

  • Functional mandibular reconstruction: prevention of the oral invalid.

    abstract::Composite mandibulectomy for carcinoma can create an "oral invalid," with difficulty in mastication. Functional reconstruction has fallen short of ideal. Three patients were seen with significant anatomic deficits and functional debilitations resulting from large composite mandibulectomies for oral carcinoma. Each pat...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Lukash FN,Sachs SA

    更新日期:1989-08-01 00:00:00

  • A combined rectus abdominis musculocutaneous flap and vascularized iliac bone graft with double vascular pedicles.

    abstract::Although a free vascularized iliac bone graft has been successfully used for the reconstruction of large bone defects, there is a serious problem of how to repair in one stage patients having a large bone defect with a very wide skin defect. A free combined rectus abdominis musculocutaneous flap and vascularized iliac...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199109000-00020

    authors: Koshima I,Soeda S,Nakayama Y,Ishii M,Harada S,Kaneko M

    更新日期:1991-09-01 00:00:00

  • Comparison of Outcomes following Autologous Breast Reconstruction Using the DIEP and Pedicled TRAM Flaps: A 12-Year Clinical Retrospective Study and Literature Review.

    abstract:BACKGROUND:There are few studies that compare the deep inferior epigastric artery perforator (DIEP) flap to the pedicled transverse rectus abdominis myocutaneous (pTRAM) flap for use in reconstructive breast surgery. The authors examined four factors that aid in decision-making: donor-site morbidity, need for surgery r...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000001747

    authors: Knox ADC,Ho AL,Leung L,Tashakkor AY,Lennox PA,Van Laeken N,Macadam SA

    更新日期:2016-07-01 00:00:00

  • Change Is Happening: An Evaluation of Gender Disparities in Academic Plastic Surgery.

    abstract:BACKGROUND:Gender disparities in academic plastic surgery are known; however, recently, professional societies have endorsed a culture of gender diversification. This study aims to evaluate the effects of these changes at faculty and leadership positions. METHODS:A cross-sectional study was conducted in June of 2018 t...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006086

    authors: Smith BT,Egro FM,Murphy CP,Stavros AG,Kenny EM,Nguyen VT

    更新日期:2019-10-01 00:00:00

  • Comparison of hemihypoglossal nerve versus masseteric nerve transpositions in the rehabilitation of short-term facial paralysis using the Facial Clima evaluating system.

    abstract:BACKGROUND:Masseteric and hypoglossal nerve transfers are reliable alternatives for reanimating short-term facial paralysis. To date, few studies exist in the literature comparing these techniques. This work presents a quantitative comparison of masseter-facial transposition versus hemihypoglossal facial transposition ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318267d5e8

    authors: Hontanilla B,Marré D

    更新日期:2012-11-01 00:00:00

  • Late recurrence of localized cutaneous melanoma: its influence on follow-up policy.

    abstract::This paper reports 11 cases of recurrence 10 years or more after primary treatment of clinically local cutaneous melanoma at the Peter MacCallum Cancer Institute. Using the product-limit method for estimating recurrence-free survival, two late recurrence rates have been calculated. The estimated late recurrence rate a...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199009000-00024

    authors: McEwan L,Smith JG,Matthews JP

    更新日期:1990-09-01 00:00:00

  • Breast reconstruction with the latissimus dorsi flap: women's preference for scar location.

    abstract:BACKGROUND:Refinements made in latissimus dorsi breast reconstruction have improved the aesthetic appearance of the breast without changing the donor-site location. The optimal location for donor-site placement, from a patient's perspective, is still unknown. The purpose of this study was to assess women's preference f...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181de1b41

    authors: Bailey S,Saint-Cyr M,Zhang K,Mojallal A,Wong C,Ouyang D,Maia M,Zhang S,Rohrich RJ

    更新日期:2010-08-01 00:00:00

  • Biology and Biomarkers for Wound Healing.

    abstract:BACKGROUND:As the population grows older, the incidence and prevalence of conditions that lead to a predisposition for poor wound healing also increase. Ultimately, this increase in nonhealing wounds has led to significant morbidity and mortality with subsequent huge economic ramifications. Therefore, understanding spe...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0000000000002682

    authors: Lindley LE,Stojadinovic O,Pastar I,Tomic-Canic M

    更新日期:2016-09-01 00:00:00

  • A modification of the great-toe transfer for thumb reconstruction.

    abstract::A modification of the great-toe-to-thumb transfer is presented, which includes sculpting the transferred toe with removal of soft-tissue pulp and bone from the lateral side of the toe. This modification provides the aesthetic advantages of the wrap-around flap while avoiding problems of bone graft resorption, pulp mob...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198809000-00033

    authors: Upton J,Mutimer K

    更新日期:1988-09-01 00:00:00

  • Benefits of the CO2 laser in oral hemangioma excision.

    abstract::Twenty-one patients with small localized oral cavity hemangiomas of the lips, tongue, and buccal mucosa are reported in this series. Although the lesions were not massive or high-flow/high-pressure vascular tumors, the simultaneous cutting and coagulation capabilities of the CO2 laser were demonstrated, rendering such...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198501000-00010

    authors: Apfelberg DB,Maser MR,Lash H,White DN

    更新日期:1985-01-01 00:00:00

  • Various methods of breast reconstruction after mastectomy: an economic comparison.

    abstract::This study is an economic comparison of various methods of breast reconstruction after mastectomy. The hospital bills of 287 patients undergoing breast reconstruction at three institutions from June of 1988 to March of 1991 were analyzed. The procedures examined included mastectomy, implant and tissue-expander reconst...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199307000-00011

    authors: Elkowitz A,Colen S,Slavin S,Seibert J,Weinstein M,Shaw W

    更新日期:1993-07-01 00:00:00

  • Nutritional deficiency of post-bariatric surgery body contouring patients: what every plastic surgeon should know.

    abstract:BACKGROUND:Bariatric surgery, particularly the Roux-en-Y gastric bypass, is currently the most effective method of sustainable weight loss for the morbidly obese patient population. Unfortunately, the nutritional adequacy of the postoperative diet has frequently been overlooked, and in the months to years that follow, ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章,评审

    doi:10.1097/PRS.0b013e31817d6023

    authors: Agha-Mohammadi S,Hurwitz DJ

    更新日期:2008-08-01 00:00:00

  • Tissue oximetry monitoring in microsurgical breast reconstruction decreases flap loss and improves rate of flap salvage.

    abstract:BACKGROUND:Since the inception of microvascular free tissue transfer, flap monitoring has been based on clinical signs. Color, capillary refill, and handheld Doppler have been used for monitoring in the postoperative period; however, subjective clinical examination may delay recognition of flap compromise. Tissue oxime...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31820436cb

    authors: Lin SJ,Nguyen MD,Chen C,Colakoglu S,Curtis MS,Tobias AM,Lee BT

    更新日期:2011-03-01 00:00:00

  • Use of Routine Pathologic Evaluation of Nonmalignant Lesions in Hand Surgery: A National Study.

    abstract:BACKGROUND:Most lesions of the upper extremity are common and benign, and many have questioned the need for routine pathologic evaluation of these specimens. The authors aim to examine the national use of routine pathologic examination of nonmalignant hand lesions to help guide health care policy and practice patterns....

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000004592

    authors: Cho HE,Kelley B,Zhong L,Chung KC

    更新日期:2018-08-01 00:00:00

  • In the Eye of the Beholder: Changes in Perceived Emotion Expression after Smile Reanimation.

    abstract:BACKGROUND:Tools to quantify layperson assessments of facial palsy are lacking. In this study, artificial intelligence was applied to develop a proxy for layperson assessments, and compare sensitivity to existing outcome measures. METHODS:Artificially intelligent emotion detection software was used to develop the emot...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000005865

    authors: Dusseldorp JR,Guarin DL,van Veen MM,Jowett N,Hadlock TA

    更新日期:2019-08-01 00:00:00

  • Lumbar Flap versus the Gold Standard: Comparison to the DIEP Flap.

    abstract:BACKGROUND:The lumbar artery perforator flap is an excellent free flap for breast reconstruction whenever the deep inferior epigastric perforator (DIEP) flap is not an option. The main indication is a lack of abdominal bulk, often seen in young BRCA-positive women seeking prophylactic amputation and immediate reconstru...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006681

    authors: Opsomer D,Vyncke T,Depypere B,Stillaert F,Blondeel P,Van Landuyt K

    更新日期:2020-04-01 00:00:00

  • Can You Trust What You Watch? An Assessment of the Quality of Information in Aesthetic Surgery Videos on YouTube.

    abstract:BACKGROUND:Videos on YouTube can be posted without regulation or content oversight. Unfortunately, many patients use YouTube as a resource on aesthetic surgery, leading to misinformation. Currently, there are no objective assessments of the quality of information on YouTube about aesthetic surgery. METHODS:YouTube was...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006463

    authors: Gray MC,Gemmiti A,Ata A,Jun B,Johnson PK,Ricci JA,Patel A

    更新日期:2020-02-01 00:00:00

  • Postpericardiotomy syndrome: its diagnosis and treatment after muscle flap closure of an infected sternal wound.

    abstract::After nearly any form of cardiac surgery, an acute febrile illness characterized by leukocytosis, pericarditis with pericardial effusion, and pleural effusion may occur. In some instances, this postpericardiotomy syndrome may suggest the presence of mediastinal infection. Treatment of postpericardiotomy syndrome is co...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:

    authors: Workman ML,Blinkhorn R,Smith AA

    更新日期:1995-09-01 00:00:00