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Influence of Silicone Sheets on Microvascular Anastomosis

  • Original Article
  • Published:
Clinical Orthopaedics and Related Research

Abstract

The use of silicone products combined with free flap transfer is well established in reconstructive surgery. We determined the risk of thrombosis as a result of direct contact between the silicone sheet and the point of microanastomosis. We performed microvascular surgery in 24 female Chinchilla Bastard rabbits weighing 3500 to 4000 g using two groups: Group 1 (n = 12), microanastomosis directly in contact with silicone sheets; and Group 2 (n = 12), microanastomosis protected by a 2 × 3 × 1-cm muscle cuff before being placed in contact with the silicone. We assessed flow-through of the microanastomosis by selective microangiography and histology at 1 and 3 weeks. All microanastomoses in Group 1 were occluded by postoperative thromboses, whereas all microanastomoses in Group 2 had adequate flow-through. Histologic analysis revealed thromboses in Group 1 formed from collagenous bundles of fiber securely attached to the intraluminal wall of the vessel. Three weeks after the procedure, these thromboses were canalized by varying small vessels. In Group 2, a slight luminal stenosis with evidence of infiltration of inflammatory cells at the microanastomosis line was observed histologically in all cases. Prefabricated flaps using silicone sheets and muscular cuffs placed around the anastomoses appear to reduce the risk of thrombosis and enhance neovascularization.

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Acknowledgments

We thank the Alexander von Humboldt Foundation, Germany (AvH Foundation) for help in financing the first author’s research scholarship at the University Hospital “rechts der Isar” in Munich, Germany, and for their scientific advice and expertise in making this publication possible. We also thank Christine Cavanna at the University of Regensburg Medical Center for careful editing of the manuscript, and Drs. M. Wenzel, A. Feucht, K. Herfeldt, and O. Petrowicz, Institute for Experimental Surgery of the University Hospital rechts der Isar of the Technical University of Munich, Germany, for help with statistical analysis and advice in performing the histologic images.

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Authors and Affiliations

  1. Department of Hand Surgery and Microsurgery, Institute of Trauma and Orthopaedics, Central University Hospital 108, Khoa B1-2, Benh vien 108, So 1 Tran Hung Dao, Hanoi, Vietnam

    The Hoang Nguyen MD, PhD

  2. Department of Plastic and Reconstructive Surgery, University Hospital “rechts der Isar”, Technical University of Munich, Munich, Germany

    The Hoang Nguyen MD, PhD, Marcus Kloeppel MD, PhD & Christoph Hoehnke MD, PhD

  3. ENT Department, University Hospital “rechts der Isar”, Technical University of Munich, Munich, Germany

    The Hoang Nguyen MD, PhD & Rainer Staudenmaier MD, PhD

Authors
  1. The Hoang Nguyen MD, PhD
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  2. Marcus Kloeppel MD, PhD
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  3. Christoph Hoehnke MD, PhD
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  4. Rainer Staudenmaier MD, PhD
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Corresponding author

Correspondence to The Hoang Nguyen MD, PhD.

Additional information

One author (CH) has received funding from the Deutsche Forschungsgemeinschaft (DFG).

Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Hoang Nguyen, T., Kloeppel, M., Hoehnke, C. et al. Influence of Silicone Sheets on Microvascular Anastomosis. Clin Orthop Relat Res 466, 3123–3129 (2008). https://doi.org/10.1007/s11999-008-0388-z

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  • DOI: https://doi.org/10.1007/s11999-008-0388-z

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