ABSTRACT
A new pair of forceps incorporating two skin hooks and needle driver tips on an Adson forceps frame is described. Its use, advantages, and disadvantages are outlined.
Subject(s)
Dermatologic Surgical Procedures , Skin Transplantation/instrumentation , Surgical Flaps , Suture Techniques/instrumentation , Canada , Equipment Design , HumansABSTRACT
A tendon approximator designed to hold tendon ends together for suturing is described. The method of use and the situations where it may be of value are described.
Subject(s)
Suture Techniques/instrumentation , Tendons/surgery , HumansABSTRACT
The circulation in microvascularized rib grafts has been compared with that in conventional rib grafts and in those augmented by a direct vascular bundle implantation into the bone grafts. A new experimental model has been designed to correlate vascular perfusion, bone scan patterns, tetracycline labeling, and histological findings in these bone grafts. Posterior microvascularized rib grafts were found to have a circulatory pattern identical to that of the normal rib. Failed microvascularized rib grafts were revascularized more slowly than conventional rib grafts. Vascular bundles implanted into rib grafts remained patent and increased the rate of revascularization. The stripping or preservation of periosteum had no observable effects on the rate or pattern of conventional rib graft revascularization. The circulation in rib grafts was accurately reflected in technetium 99 bone scans, as was the patency of the anastomoses of microvascularized rib grafts and of implanted vascular bundles. In contrast, tetracycline labeling was repeatedly observed in avascular areas of bone grafts and, therefore, is not a reliable indicator of bone graft circulation.
Subject(s)
Blood Vessels/transplantation , Bone Transplantation , Ribs/transplantation , Animals , Bone Marrow/blood supply , Bone and Bones/blood supply , Bone and Bones/diagnostic imaging , Diphosphonates , Dogs , Graft Occlusion, Vascular/pathology , Microcirculation , Perfusion , Periosteum/blood supply , Radionuclide Imaging , Ribs/blood supply , Silicone Elastomers , Technetium , Technetium Tc 99m Medronate , TetracyclineABSTRACT
Previous reports have stressed the importance of the nutrient blood supply in rib grafts transferred by microvascular anastomoses. In the present experimental study, we have demonstrated that a rib graft transferred by microvascular anastomoses based on periosteal vessels can survive; vascular clearing studies demonstrated that the vascularity of these grafts extends not only into the cortex but the medulla as well. The relative facility of harvesting these grafts (compared with those based on nutrient vessels) should make them the favored choice. Technetium bone scintigraphy proved accurate in the assessment of both vascular pattern and microanastomotic patency. Tetracycline labeling did not correlate well with the patency of a rib graft's pedicle blood supply.
