Microvascular Anastomosis Using Less Sutures and Fibrin Glue in Male Albino Rat: An Experimental Study.

Background: Traditional microvascular anastomosis can be timeconsuming, which raises the risk of thrombosis. Damage to the endothelium during the process triggers a repair mechanism that involves platelet aggregation, smooth muscle cell proliferation, and thickening of the endothelium. Microvascular anastomosis plays a vital role in free flap transfers and replantation surgeries. Although standard suturing remains the preferred technique, it presents challenges due to its technical difficulty, extended duration, and potential for vessel wall trauma. Fibrin glue, derived from a combination of autologous cryoprecipitate and thrombin, was originally introduced for peripheral nerve repair in humans. The success of these early uses led to its expanded application in areas such as wound closure, skin grafting, and osteotomy healing. This study aims to evaluate the effectiveness of fibrin adhesive in addressing these challenges within the context of microvascular anastomosis. Methods: This experimental study included 22 male Sprague-Dawley albino rats, the rats were divided into two groups Group (1): Experimental group, we used 4 core sutures with 9/0 polypropylene placed 90 degrees from each other and 0.1 ml of fibrin glue at site of anastomosis. Group (2): As a control group we used the standard repair technique of the transected artery by 5-8 primary sutures with 9/0 polypropylene. Results: The use of fibrin adhesive significantly decreased both the number of sutures required and the time needed to complete the anastomosis. The immediate and long-term patency rates were not adversely affected by the application of fibrin glue. Histological analysis of the anastomosed vessels revealed no significant differences between the two techniques. Conclusions: In conclusion, the application of fibrin adhesive did not produce any adverse effects in microvascular anastomosis. The authors advocate for using fibrin adhesive in clinical settings, particularly in more complex cases where multiple microvascular anastomoses are necessary. [ABSTRACT FROM AUTHOR]