Comparison of continuous and interrupted suture techniques in microvascular anastomosis.

We evaluated the efficacy of the continuous suture technique (CST) in arteries and veins with varying external diameters (ED). In study 1 a direct end-to-end anastomosis was performed in 5 groups of animals (n = 15 in each group): group 1, rabbit carotid artery (ED, 1.8-2.0 mm); group 2, rabbit femoral artery (ED, 1.4-1.6 mm); group 3, rat femoral artery (ED, 0.7-0.9 mm); group 4, rabbit femoral vein (ED, 2.0-2.2 mm); and group 5, rat femoral vein (ED, 1.0-1.2 mm). In study 2 a graft from the femoral vein was interposed into the carotid artery, with a ratio of the diameter of graft to artery of 1.3:1 in the rats (group 6, n = 12) and 1:1 in the rabbits (group 7, n = 12). In each animal the vessel on one side was repaired using CST and the opposite vessel using the interrupted suture technique. Vessel samples were harvested 1, 2, and 4 weeks after anastomosis. The CST significantly reduced anastomosis time by up to 47% in arteries and 41% in veins. Bleeding time and blood loss were also significantly reduced with CST. Similar results were found in study 2. The total thrombosis rate was 8%, but no significant patency difference was noted between the CST and the interrupted suture technique in any vessel category. We conclude that the CST is a reliable and time-saving procedure in microvascular anastomosis of arteries with diameters greater than 0.7 mm and of veins with diameters greater than 1.0 mm.

Duke Scholars

Author James Randolph Urbaniak Orthopaedic Surgery