Experimental microvascular allo and hetero grafts.
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Biomedical subjects
Publications and source records attributed to T Harashina.
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The success of a free flap transfer depends entirely on the suture of a paired artery and vein between the donor and recipient sites. The interrupted suturing method with biangulation or successive interrupted suturing is the method of choice. The size of the site, small or large, does not effect either the resulting patency or the process of intimal healing. When occlusion of the anastomosed site is encountered, the transferred free flap can be saved by exploration within 6 hours after surgery. Reapplication of the clamp proximally or distally to the anastomosed site does not change the patency rate. Free groin flaps can be successfully transferred in 2 orthopedic cases.
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A technique for microvascular anastomoses is described. It leaves one suture united until the last, a maneuver which helps to avoid picking up the posterior wall with the anterior wall.
A deltovertebral flap based on the perforating cutaneous branches of the posterior intercostal vessels (the exact opposite of the deltopectoral flap) was used successfully to cover a large scalp defect. The procedure is a rather hazardous one, due to the numerous stages and the awkward postoperative position. However, it may be used to repair the lateral aspect of the neck or the occipital region when a flap is necessary and other methods are not feasible.
We present two new, one-stage methods for resurfacing a part of the face-- (1) the microvascular transfer of a free retroauricular flap, and (2) an island flap from the galea covered by a full-thickness skin graft from the retroauricular region. Both procedures provided the same good color match, without leaving a readily visible donor scar.
We present a successful clinical case (perhaps the first) of primary reconstruction of the breast after radical mastectomy by use of a free skin-fat-muscle flap.
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Examination with the S.E.M. shows that 5 days after surgery the microanastomoses area is covered with pseudointima, and the regeneration of the intima is completed within two weeks. Comparing the two different suture techniques (large bites and small bites), there are no differences between them in the resultant patency rates. The large bites produce less immediate leakages. There were no significant differences in the process of intimal healing.
An experiment was done with albino rats to determine whether the arterial clamp should be reapplied proximal or distal to the anastomosis when revising a venous anastomosis in microvascular surgery. Our findings showed that the reapplication of clamps should be avoided if possible. However, if it is necessary to reapply an arterial clamp, it may be placed either proximal or distal to the anastomosis - with almost the same incidence of patency resulting.
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