RESUMO
The most common technical error associated with microvascular anastomotic failure is accidentally snagging the opposite wall and including it in the stitch, thereby reducing the vessel lumen diameter or occluding it altogether. A simple, safe microsuturing technique is described that combines the use of the slip-knot and the suspension technique in a procedure that allows direct visual inspection of suture placement from first to last stitch. This technique is applicable to end-to-end and end-to-side microvascular anastomoses, for thick-walled ducts such as the vas deferens and the fallopian tube, and in laparoscopic suturing.
Assuntos
Microcirurgia/métodos , Técnicas de Sutura , Procedimentos Cirúrgicos Vasculares/métodos , Anastomose Cirúrgica/métodos , Animais , Feminino , Masculino , Microcirculação/cirurgia , Ratos , Ratos EndogâmicosRESUMO
Whatever surgical procedure is adopted in Dupuytren's contracture, it demands the utmost finesse and delicacy of technique. Even so, the functional and cosmetic results are often equivocal, but in our view Skoog's technique offers the most practical and effective method of treatment. It offers the following advantages: Duration of operation: In a case of moderate severity affecting only 2 digits the operation can be completed in 30-40 minutes. The surgical trauma is minimal and post-operative complications are therefore minimal. Recovery of function is rapid and there is complete absence of the disturbances associated with prolonged immobilisation. The relapse rate is minimal and certainly no greater than that associated with more radical techniques. The only disadvantage, if it can be so considered, is that the surgeon must be perfectly familiar with the detailed anatomy of the palm and fingers. Since the method does not involve the more extensive exposure and display of all the structures, as in other methods, it is easier in the absence of such knowledge to do accidental damage.
