Premium
Further investigation of secondary venous obstruction
Author(s) -
Angel Michael F.,
Knight Kenneth R.,
Amiss L. R.,
Morgan Raymond F.
Publication year - 1992
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.1920130512
Subject(s) - medicine , ischemia , surgery , venous thrombosis , anastomosis , vein , microsurgery , thrombosis , anesthesia
The first ischemic insult a tissue suffers is primary (1°). A second ischemic episode, such as thrombosis after free tissue transfer may be regarded as secondary (2°) ischemia. The current study investigated 2° ischemia in rodent epigastric flaps. Flaps were elevated in 50 Sprague‐Dawley rats: group 1 had 5 hours 1° venous ischemia induced by placement of microvascular clamps; group 2 was like group 1, except venous continuity was re‐established by venous anastomosis after resection of the venous segment previously microclamped; group 3 had 15 minutes of 1° ischemia, 24 hr later 5 hr of 2° venous ischemia was induced by placement of microvascular clamps; group 4 was like group 3, except the venous segment was excised. Necrosis was evaluated on postoperative day 7. Both secondary ischemic groups had significantly less flap survival than the corresponding primary ischemic groups ( P <0.001 for both). Resection of a portion of the vein and subsequent microanastomosis did not reduce flap survival (NS). Secondary venous ischemia of 5‐hr duration is poorly tolerated by rodent skin flaps. There was no difference in flap survival in those flaps whose veins were clamped for 5 hr compared to those flaps whose clamped venous segments were resected and re‐anastomosed. © Wiley‐Liss, Inc.