The use of absorbable sutures in laser-assisted microvascular anastomoses

The efficacy of the laser in performing microvascular anastomoses has been well established in the laboratory using a number of wavelengths. These studies have concluded that laser-assisted microvascular anastomoses are at least comparable to, if not superior to, ordinary suture techniques. The advantages have been the diminished foreign body reaction that occurs as a consequence of using only a few stay sutures to hold the vessels in approximation while the laser bonding is performed, as well as the rapidity of the surgery. We have already shown that absorbable sutures (polyglactin 910) are as efficacious as standard nonabsorbable sutures (nylon) in both arterial and venous microanastomoses. The current study was undertaken to see if the foreign body reaction could be diminished even further by the use of absorbable 10.0 sutures and compare these findings to laser-assisted microvascular anastomoses performed with nonabsorbable sutures. The carbon dioxide milliwatt laser was used to perform laser-assisted microvascular anastomoses in rat femoral arteries and veins. Patency rates and histological response were compared at intervals of 3 days and 1, 2, 4, 8, and 12 weeks postoperatively. Both arterial and venous patency rates were comparable (overall absorbable, 91.2%-52/57; overall nonabsorbable, 87.7%-50/57), as was the degree of inflammation and fibrosis. We conclude that absorbable sutures can be used for laser-assisted microvascular anastomoses and have the potential of allowing healing to occur without any foreign material within the surgical site.