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Technical tips to trim the stump of a nonspurting recipient artery.

Miyamoto S, Fukunaga Y, Sakuraba M - Plast Reconstr Surg Glob Open (2014)

View Article: PubMed Central - PubMed

Affiliation: Division of Plastic and Reconstructive Surgery National Cancer Center Hospital Tokyo, Japan.

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The selection of appropriate recipient vessels is essential for successful free flap transfer... When a blood spurt cannot be observed from the stump of a recipient artery, the artery should be shortened until a good spurt occurs... For such shortening, most microsurgeons cut the arterial stump with straight microscissors in a guillotine fashion (,, which demonstrates preparation of an arterial stump in a guillotine fashion, http://links.lww.com/PRSGO/A58)... When the cut reaches the healthy portion of the artery, a blood spurt immediately occurs... The clamp is then applied proximally, and the vessel wall is trimmed with a circumferential excision (Fig. 1)... The main advantage of our method is that it minimizes the sacrificed length of the vessel... Our method also prevents overshortening of recipient vessels... In addition, circumferential excision of the vessel wall causes less damage to the intima than does the guillotine cut and prevents intimal separation (,, which demonstrates preparation of an arterial stump in a circumferential fashion, http://links.lww.com/PRSGO/A59)... We believe that these technical tips will help microsurgeons to appropriately shorten nonspurting recipient arteries... The authors have no financial interest to declare in relation to the content of this article... The Article Processing Charge was paid for by the authors.

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Preparation of an arterial stump with our method. A, A longitudinal cut in the vessel wall is gradually made with curved microscissors without clamping. B, When the cut reaches the healthy portion of the artery, a blood spurt can be immediately observed. C, The vessel wall is trimmed with a circumferential excision after the clamp has been applied proximally. D, A recipient artery of adequate length and with a smooth lumen can be maintained.Video 1. See video, Supplemental Digital Content 1, which displays preparation of an arterial stump in a guillotine fashion, http://links.lww.com/PRSGO/A58.Video 2. See video, Supplemental Digital Content 2, which displays preparation of an arterial stump in a circumferential fashion, http://links.lww.com/PRSGO/A59.
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Figure 1: Preparation of an arterial stump with our method. A, A longitudinal cut in the vessel wall is gradually made with curved microscissors without clamping. B, When the cut reaches the healthy portion of the artery, a blood spurt can be immediately observed. C, The vessel wall is trimmed with a circumferential excision after the clamp has been applied proximally. D, A recipient artery of adequate length and with a smooth lumen can be maintained.Video 1. See video, Supplemental Digital Content 1, which displays preparation of an arterial stump in a guillotine fashion, http://links.lww.com/PRSGO/A58.Video 2. See video, Supplemental Digital Content 2, which displays preparation of an arterial stump in a circumferential fashion, http://links.lww.com/PRSGO/A59.

Mentions: We invented an efficient and atraumatic method for trimming nonspurting recipient arteries. First, we gradually make a longitudinal cut in the vessel wall with curved microscissors. During this step, the artery should not be clamped. When the cut reaches the healthy portion of the artery, a blood spurt immediately occurs. The clamp is then applied proximally, and the vessel wall is trimmed with a circumferential excision (Fig. 1).5


Technical tips to trim the stump of a nonspurting recipient artery.

Miyamoto S, Fukunaga Y, Sakuraba M - Plast Reconstr Surg Glob Open (2014)

Preparation of an arterial stump with our method. A, A longitudinal cut in the vessel wall is gradually made with curved microscissors without clamping. B, When the cut reaches the healthy portion of the artery, a blood spurt can be immediately observed. C, The vessel wall is trimmed with a circumferential excision after the clamp has been applied proximally. D, A recipient artery of adequate length and with a smooth lumen can be maintained.Video 1. See video, Supplemental Digital Content 1, which displays preparation of an arterial stump in a guillotine fashion, http://links.lww.com/PRSGO/A58.Video 2. See video, Supplemental Digital Content 2, which displays preparation of an arterial stump in a circumferential fashion, http://links.lww.com/PRSGO/A59.
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Related In: Results  -  Collection

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Figure 1: Preparation of an arterial stump with our method. A, A longitudinal cut in the vessel wall is gradually made with curved microscissors without clamping. B, When the cut reaches the healthy portion of the artery, a blood spurt can be immediately observed. C, The vessel wall is trimmed with a circumferential excision after the clamp has been applied proximally. D, A recipient artery of adequate length and with a smooth lumen can be maintained.Video 1. See video, Supplemental Digital Content 1, which displays preparation of an arterial stump in a guillotine fashion, http://links.lww.com/PRSGO/A58.Video 2. See video, Supplemental Digital Content 2, which displays preparation of an arterial stump in a circumferential fashion, http://links.lww.com/PRSGO/A59.
Mentions: We invented an efficient and atraumatic method for trimming nonspurting recipient arteries. First, we gradually make a longitudinal cut in the vessel wall with curved microscissors. During this step, the artery should not be clamped. When the cut reaches the healthy portion of the artery, a blood spurt immediately occurs. The clamp is then applied proximally, and the vessel wall is trimmed with a circumferential excision (Fig. 1).5

View Article: PubMed Central - PubMed

Affiliation: Division of Plastic and Reconstructive Surgery National Cancer Center Hospital Tokyo, Japan.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The selection of appropriate recipient vessels is essential for successful free flap transfer... When a blood spurt cannot be observed from the stump of a recipient artery, the artery should be shortened until a good spurt occurs... For such shortening, most microsurgeons cut the arterial stump with straight microscissors in a guillotine fashion (,, which demonstrates preparation of an arterial stump in a guillotine fashion, http://links.lww.com/PRSGO/A58)... When the cut reaches the healthy portion of the artery, a blood spurt immediately occurs... The clamp is then applied proximally, and the vessel wall is trimmed with a circumferential excision (Fig. 1)... The main advantage of our method is that it minimizes the sacrificed length of the vessel... Our method also prevents overshortening of recipient vessels... In addition, circumferential excision of the vessel wall causes less damage to the intima than does the guillotine cut and prevents intimal separation (,, which demonstrates preparation of an arterial stump in a circumferential fashion, http://links.lww.com/PRSGO/A59)... We believe that these technical tips will help microsurgeons to appropriately shorten nonspurting recipient arteries... The authors have no financial interest to declare in relation to the content of this article... The Article Processing Charge was paid for by the authors.

No MeSH data available.


Related in: MedlinePlus