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Experimental and clinical application of microvascular surgery
Annals of Surgery
|February 1, 1975
Summary
This study details microvascular anastomosis techniques for vessel repair. Successful rabbit ear replantation improved significantly, and toe-to-thumb transplants showed promising functional outcomes in reconstructive surgery.
Area of Science:
- Microsurgery
- Vascular Anastomosis
- Reconstructive Surgery
Background:
- Developing techniques for anastomosing small vessels (≤1 mm) is crucial for reconstructive surgery.
- Previous attempts at rabbit ear replantation had low survival rates.
Purpose of the Study:
- To develop and evaluate techniques for microvascular anastomosis.
- To assess the efficacy of digital replantation and free toe-to-thumb transplantation.
Main Methods:
- Rabbit ear replantation studies (two series of 80 attempts each).
- Free transplantation of great toe and second toe to reconstruct thumbs.
- Analysis of 36 digital replantation cases involving 65 finger amputations.
Main Results:
- Rabbit ear survival improved from 3/80 to 35/80 in the second series, with venous obstruction being a primary failure cause.
- Great toe-to-thumb transplant showed good function after 6 months; second toe-to-thumb transplant had satisfactory function after 9 months.
- Digital replantation had a 69% survival rate (45/65 fingers), with arterial obstruction being the main failure cause in this group.
Conclusions:
- Improved microvascular techniques enhance the success of rabbit ear replantation.
- Toe-to-thumb transplantation is a viable option for thumb reconstruction, with variations in technical difficulty.
- Digital replantation is successful, emphasizing the importance of repairing at least one artery and two veins per digit, and prompt re-exploration for circulatory issues.