Penoscrotal avulsion injuries are rare surgical emergencies. The best treatment for penile avulsions is split skin graft, although late results of split-grafted scrotal avulsions are not superior. Scrotal skin avulsions require additional judgment for the treatment, because there are several available treatment options. Scrotal skin remnants must be used to cover whenever possible.
An experimental model for producing venous thrombosis was developed in end-to-end anastomoses of femoral veins in rats. The anastomoses were performed using a suture (9-0 suture-70 microns needle) with a knot 1 cm from the needle. The knot was formed by making either six or eight half-hitches in one throw of the suture. Vessel patency was assessed through the direct "milking test" at 20 min and 24 hrs. The incidence of thrombosis when using one knot with six half-hitches ranged from 20% to 40% and with eight half-hitches, from 50% to 70%. The incidence of femoral vein thrombosis varied directly with the presence and size of the knot. In this model, thrombosis was induced by exaggerating vessel injuries that may occur when performing routine microvascular anastomoses. This study demonstrates a reproducible thrombogenic model which mimics clinical practice and may be used to study the effects of local and systemic antithrombogenic agents.
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