An easy method of vascular anastomosis for replantation of fingertips

Many cases of successful replantation of fingertips have been reported; however, it still remains difficult for an inexperienced surgeon to anastomose very small vessels (especially veins of the fingertip) because their walls and lumina cannot be clearly defined. The authors report a simple method which is useful for anastomosis of small vessels. A colored silicone background is cut into a small, thread-like segment, and both ends are tapered. This segment is then introduced into the vessel lumen to serve as a vascular stent. The silicone vascular stent makes it easy to identify the vessel lumen and then to suture the vessel edges. It also prevents a through-stitch, the most common cause of anastomosis failure with small vessels. The silicone vascular stent is removed before the last suture is tied. This technique has been used for suturing small veins in the finger pulp or small arteries in zone I, and it will be most helpful for the inexperienced microsurgeon.