A Hemodynamic Study of the Effects of Arterial Anastomoses With Interrupted Simple Versus Horizontal Mattress Sutures on Rat Epigastric Flap Perfusion

Orak, İbrahim; Güneren, Ethem; Yıldız, Levent

doi:10.1097/01.sap.0000204035.77692.a1

Cited by 3 publications

(1 citation statement)

References 40 publications

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“…In contrast, this can easily occur to the tissue enclosed by an interrupted suture. [20] In addition, the current suture might be more favorable in favor of the adjustment excess extension to equilibrate with surrounding areas of less tension by minute movements of tissue. Another factor is related to the slick properties of a continuous monofilament plastic suture line, which may be able to expand and contract depending on intraluminal forces.…”

Section: Discussionmentioning

confidence: 99%

Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute

Yang¹,

Chen²,

et al. 2019

Medicine

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We aimed to investigate the new continuous horizontal mattress anastomosis for pediatric patients who underwent emergency or electively laparotomy. From June 2012 to June 2017, 858 patients undergoing intestinal anastomosis were reviewed retrospectively, including 369 patients with the new continuous horizontal mattress anastomosis and 489 patients with traditional 2 layer interrupted anastomosis, served as control. Propensity score matching was performed to adjust for selected baseline variables. The primary outcome, anastomosis complications and clinical outcomes, including postoperative gastrointestinal function recovery, overall expenditure, and postoperative hospital stay were compared between the 2 groups. Patients with the new manual anastomosis had advantageous postoperative outcomes than those with the traditional 2 layer interrupted anastomosis. A mean of 11.4 minutes was required to construct the new manual single-layer anastomosis versus 18.5 minutes for the traditional anastomosis ( P < .001). A reduction trend for postoperative anastomotic complications was indicated in patients receiving horizontal mattress anastomosis (odds ratio [OD] (95% confidence interval [CI]), 0.56 (0.37–0.84); P = .004), including peritonitis or abscess (OD [95% CI], 0.56 (0.32–0.98); P = .026), anastomotic leakage (OD [95% CI], 0.39 [0.12–1.27]; P = .088), and anastomotic strictures ( P = .26). Mean length of stay was 10.9 ± 2.9 days for the new manual anastomosis group and 11.3 ± 3.5 days for traditional 2-layer anastomosis patients ( P = .12). Beneficial effects of the new manual anastomosis were demonstrated in terms of anastomotic complications, and length of hospital stay in the pediatric patients. Furthermore, it is a novel, feasible and safe method that may simplify the surgical procedure in anastomoses.

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Section: Discussionmentioning

confidence: 99%

Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute

Yang¹,

Chen²,

et al. 2019

Medicine

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Management of a Large Gap between Bladder and Urethra Immediately Postprostatectomy

Stolzenburg

Robert

Constantinides

et al. 2008

Journal of Endourology

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Effects of hyperbaric oxygen preconditioning on ischemia-reperfusion inflammation and skin flap survival

QI,

GAO,

WANG

et al. 2013

Chinese Medical Journal

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Background Hyperbaric oxygen preconditioning (HBO) is a new method of ischemia preconditioning. In this study, we examined its effects on skin flap survival and the mechanisms involved. Methods Thirty-six rats were divided into three groups: HBO preconditioning, control, and sham groups. An extended epigastric adipocutaneous flap based on the right superficial epigastric artery and vein was raised. A 3-hour period of flap ischemia was induced by clamping the pedicle vessels with a microvascular clamp. At the end of ischemia induction, the clamp was removed and the flap was resutured. Rats in the HBO preconditioning group were treated with HBO four times before surgery. Microcirculation in the skin flap was measured on postoperative days 1, 3 and 5. The size of the flap was measured on postoperative day 5, before the animals were sacrificed. Samples of the skin flap were prepared and stained with hematoxylin and eosin. The levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in the flap samples were measured. Results Surviving flap size was significantly higher in the HBO preconditioning group compared with controls, with a reduced inflammatory response and increased perfusion. IL-1, TNF-α, and IL-6 levels in the HBO preconditioning group were lower than in controls. Conclusions HBO preconditioning improved flap survival in this ischemia-reperfusion rat model. The mechanisms responsible for this effect may relate to attenuation of the inflammatory response and increased flap perfusion following HBO preconditioning.

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A Hemodynamic Study of the Effects of Arterial Anastomoses With Interrupted Simple Versus Horizontal Mattress Sutures on Rat Epigastric Flap Perfusion

Cited by 3 publications

References 40 publications

Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute

Reduced rate of dehiscence after implementation of a novel technique for creating colonic anastomosis in pediatric patients undergoing intestinal anastomosis in a single institute

Management of a Large Gap between Bladder and Urethra Immediately Postprostatectomy

Effects of hyperbaric oxygen preconditioning on ischemia-reperfusion inflammation and skin flap survival

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