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Updated: Jun 7, 2025
Step By Step: Microsurgical training method combining two nonliving animal models
Published on: May 9, 2015
[Microsurgical vascular suture]
Lilly Maxine Mengen1, Raymund E Horch2, Andreas Arkudas2
1Plastisch- und Handchirurgische Klinik, Universitätsklinik Erlangen, Krankenhausstr. 12, 91054, Erlangen, Deutschland. lilly.mengen@uk-erlangen.de.
Objective:
Anastomosis of two vessels by end-to-end or end-to-side suturing to create an uninterrupted blood flow between the two vessels.
Indications:
Transplantations; replantations; vascular trauma.
Contraindications:
Active infections in the area to be vascularized or surgical site; large differences in caliber between the vessels; hypercoagulability; extensive tissue damage.
Surgical Technique:
First, clamping, cleaning and flushing of the vessel ends; adaptation of the vessel ends using end-to-end or end-to-side anastomosis, using an end-to-side anastomosis if an existing vessel axis should not be interrupted; creation of the anastomosis using a single button suture or continuous suture technique; careful avoidance of puncturing the posterior wall and exact adaptation of the vessel ends without leaks; release of the blood flow and examination of the anastomosis.
Postoperative Management:
Postoperative avoidance of traction, tension, pressure and shear forces on the anastomosis; regular blood flow checks of the revascularized tissue or flap; sufficient anticoagulation.
Results:
An atraumatic and gentle suturing technique is a basic requirement for a successful anastomosis. Special suturing techniques can improve the anastomosis of fragile vessels.
