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Stabilization of microvascular pedicles in intricate locations using fibrin glue
Author(s) -
Schwabegger Anton H.,
Engelhardt Timm O.,
Jeschke Johannes
Publication year - 2008
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.20536
Subject(s) - fibrin glue , medicine , microsurgery , distension , surgery , anastomosis , blood vessel , artery , anatomy , torsion (gastropod) , psychiatry
In reconstructive microsurgery, it is occasionally advantageous to use long recipient or donor vessels for optimal flap inset. These long vessels are prone to kinking or torsion along their longitudinal axis from vessel distension during blood inflow and rising blood pressure. More often than arteries, the veins can also be compressed by overlying tissue sutured under tension or by developing edema. Reanastomosis can no longer be feasible or desirable for several reasons, and the elongated vessels may have to be shifted to a curved course. To avoid detrimental kinking or torsion, fibrin glue can be administered along this new vessel course in order to ensure stabilization. In 20 such cases, we successfully avoided complications when the danger of kinking, torsion, or vein compression was evident after successful anastomosis. On the basis of this experience, we recommend the use of fibrin glue in microsurgical procedures, especially for vessels in intricate geometrical locations. © 2008 Wiley‐Liss, Inc. Microsurgery, 2008.