Abnormal vein patterns on the feet: two case reports.

There are many variable variants of the posterior tibial veins and these are extremely important for the venous circulation of the feet. Due to the complex and variable nature of the lower extremity veins, their drainage is particularly important in some surgical operations including flap operations and the treatment of important pathological conditions such as deep vein thrombosis. The plantar surface of the foot and the tarsal tunnel have significant neurovascular structures. Therefore it is extremely difficult to determine a safe zone when working in this region, especially for surgeons. In these two cases, abnormal vein patterns with rare anastomoses with their different drainage patterns and the fenestration were observed in the right and left feet and medial region of the ankle of male cadavers during the routine dissection. The clinical importance of this condition was particularly discussed. There are very limited cadaver studies to find out the relationship between the posterior tibial veins and great saphenous vein due to the difficulty of working on surgically deep vein thrombosis and some flap techniques. Therefore the region should be well known anatomically. Thanks to the variations and the anastomoses in our study, we aim to contribute to the studies to understand the complex structure of the region.

Early effects of fibrin sealant on colonic anastomosis in rats: an experimental and case-control study.

BACKGROUND: Leakage from colonic anastomoses leads to mortality and morbidity. Fibrin adhesives can be used to increase the strength of the anastomosis. In this study, we evaluated the early effects of fibrin sealant and hyaluronic acid-carboxymethylcellulose on colonic anastomosis in rats. METHODS: Anastomoses were made in the descending colon of 38 female Wistar-Albino rats, in three groups: control group (n = 12), group 1 treated with hyaluronic acid-carboxymethylcellulose (n = 16), and group 2 treated with fibrin sealant (n = 10). After 72 hours, adhesion scores, bursting pressure, rupture strength and histopathologic healing scores were evaluated. RESULTS: Due to postoperative mortality, we evaluated 10, 10 and 9 rats in the control group and in groups 1 and 2, respectively. Of these, we excluded 4, 5 and 4 rats that had macroperforations at autopsy. In the remaining rats, bursting pressure (123.2 +/- 14.8 mmHg) and rupture strength (400 +/- 16 mg) in the fibrin sealant group were significantly greater than in the two other groups ( CONTROL: 68.0 +/- 10.6 p = 0.006 and 325 +/- 52 p = 0.009; Group 1: 74.0 +/- 9.8 p = 0.03, 330 +/- 27 p = 0.016). However, we did not observe any significant difference between adhesion scores (2.5 +/- 0.6, 2.0 +/- 0.7, 2.0 +/- 0.7, p = 0.343). CONCLUSIONS: In this experimental study, fibrin sealant increased bursting pressure and rupture strength of colonic anastomoses while hyaluronic acid-carboxymethylcellulose had no effects in rats, but both of them showed no effect on adhesion scores. In order to use fibrin sealant to decrease the rate of early leakages from colonic anastomoses, further studies have to be performed.