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Relationship between flow and incidence of thrombosis in polytetrafluoroethylene vascular grafts in free microvascular flaps in lambs.
- Source :
-
Scandinavian journal of plastic and reconstructive surgery and hand surgery [Scand J Plast Reconstr Surg Hand Surg] 1999 Sep; Vol. 33 (3), pp. 287-94. - Publication Year :
- 1999
-
Abstract
- We have done an experimental study in lambs in which we investigated the influence of flow rate on free microvascular flaps using polytetrafluoroethylene (PTFE) vascular grafts. We set up five surgical groups in which blood flow was progressively increased through the PTFE vascular graft. In group I (venous autograft) we observed just one vascular thrombosis which was located at the site of the anastomosis. In group II (PTFE 3 x 10 mm) all the microvascular flaps became necrosed after the third postoperative day. In group III (PTFE 3 x 10 mm) necrosis also developed in all cases, but the anastomoses remained permeable no longer than eight days. In group IV (3 x 15 mm) the permeability in the microvascular free flaps was about 40% after 21 days, and in group V (3 x 10 mm) it reached 70%. To match graft flow rates with flap survival we did a regression analysis of flow rates for groups II, III, and V and the corresponding survival periods for the flaps. There was a clear and highly significant relationship (r = 0.717, p = 0.0001). In conclusion, it is necessary to maintain blood flow through the prosthesis at a rate higher than the thrombogenic threshold. When the flow rate in the vessels through the PTFE grafts was higher, the viability of the flaps was better. The ideal surgical technique should always be based on an arteriovenous fistula distal to the PTFE vascular graft. It is necessary to maintain blood flow through a prosthesis at a rate higher than the thrombogenic threshold.
- Subjects :
- Animals
Blood Flow Velocity
Blood Vessel Prosthesis Implantation
Laser-Doppler Flowmetry
Microsurgery adverse effects
Microsurgery methods
Necrosis
Polytetrafluoroethylene
Regression Analysis
Sheep
Statistics, Nonparametric
Surgical Flaps adverse effects
Surgical Flaps pathology
Thrombosis blood
Blood Vessel Prosthesis adverse effects
Surgical Flaps blood supply
Thrombosis etiology
Subjects
Details
- Language :
- English
- ISSN :
- 0284-4311
- Volume :
- 33
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Scandinavian journal of plastic and reconstructive surgery and hand surgery
- Publication Type :
- Academic Journal
- Accession number :
- 10505441
- Full Text :
- https://doi.org/10.1080/02844319950159253