CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2020; 05(02): e101-e106
DOI: 10.1055/s-0040-1719152
Original Article

Simple Interrupted Microvascular Anastomosis: Review of Four Sutures Placement Sequences

Brianne Sullivan
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Michael Zoppo
2   BlueTeam Design, Raleigh, North Carolina
,
Alice Yao
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
,
Peter W. Henderson
1   Division of Plastic and Reconstructive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
› Author Affiliations

Abstract

Background Microsurgical anastomosis is a delicate, highly nuanced procedure that can be done in several different ways; the most basic approach to performing microsurgical anastomoses is by using simple interrupted sutures, but even within that approach, there are different sequences by which the sutures can be placed. To date, there is no review of these sequences and the advantages and disadvantages of each.

Methods A PubMed search was performed in October 2019 that sought all published descriptions of simple interrupted microsurgery techniques. Keywords included were “microvascular anastomosis,” “microvascular anastomosis technique,” “simple interrupted,” and “microsurgery.”

Results Four simple interrupted microsurgery techniques were identified: triangulation, 12 o'clock to 6 o'clock, posterior-wall-first, and 3 o'clock to 9 o'clock-side-side. Additionally, there is no uniform nomenclature that describes the techniques for simple interrupted microvascular anastomoses.

Conclusion This study identified four distinct sequences for the placement of simple interrupted sutures for microsurgical anastomosis and the advantages and disadvantages of each, and for the first time described them utilizing standardized nomenclature.



Publication History

Received: 23 June 2020

Accepted: 25 August 2020

Article published online:
17 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Alghoul MS, Gordon CR, Yetman R. et al. From simple interrupted to complex spiral: a systematic review of various suture techniques for microvascular anastomoses. Microsurgery 2011; 31 (01) 72-80
  • 2 Hou SM, Seaber AV, Urbaniak JR. An alternative technique of microvascular anastomosis. Microsurgery 1987; 8 (01) 22-24
  • 3 Agko M, Ciudad P, Chen HC. “Airborne” suture tying technique: simple steps to make it easy. Head Neck 2017; 39 (12) 2558-2561
  • 4 Kim E, Singh M, Akelina Y, Shurey S, Myers SR, Ghanem AM. Effect of microvascular anastomosis technique on end product outcome in simulated training: a prospective blinded randomized controlled trial. J Reconstr Microsurg 2016; 32 (07) 556-561
  • 5 Harris GD, Finseth F, Buncke HJ. Posterior-wall-first microvascular anastomotic technique. Br J Plast Surg 1981; 34 (01) 47-49
  • 6 Hou SM, Seaber AV, Urbaniak JR. An alternative technique of microvascular anastomosis. Microsurgery 1987; 8 (01) 22-24
  • 7 Chen ZW, Yang DY, Chang DA. Microsurgery Shanghai Scientific and Technical Publishers. Berlin; New York: Springer-Verlag; 1982
  • 8 Yu HL, Sagi A, Ferder M, Strauch B. A simplified technique for end-to-end microanastomosis. J Reconstr Microsurg 1986; 2 (03) 191-194
  • 9 Lee BY, Thoden WR, Brancato RF, Kavner D, Shaw W, Madden JL. Comparison of continuous and interrupted suture techniques in microvascular anastomosis. Surg Gynecol Obstet 1982; 155 (03) 353-357
  • 10 Tetik C, Ünal MB, Kocaoğlu B, Erol B. Use of continuous horizontal mattress suture techniques in microsurgery: an experimental study in rats. J Hand Surg Am 2005; 30 (03) 587-595
  • 11 Jacobson JH, Suarez EL. Microsurgery in Anastomosis of Small Vessels. Surg Forum 1960; 11: 243
  • 12 Gordon L. Advances in microsurgery. Surg Technol Int 1991; I: 425-427
  • 13 Cobbett JR. Microvascular surgery. Surg Clin North Am 1967; 47 (02) 521-542
  • 14 Rickard RF, Hudson DA. A history of vascular and microvascular surgery. Ann Plast Surg 2014; 73 (04) 465-472
  • 15 Jacobson II JH. The early days of microsurgery in Vermont. Mt Sinai J Med 1997; 64 (03) 160-163
  • 16 Firsching R, Terhaag PD, Müller W, Frowein RA. Continuous and interrupted suture technique in microsurgical end?to?end anastomosis. Microsurgery 1984; 5: 80-84
  • 17 Turan T, Ozçelik D, Kuran I. et al. Eversion with four sutures: an easy, fast, and reliable technique for microvascular anastomosis. Plast Reconstr Surg 2001; 107 (02) 463-470
  • 18 Chen YX, Chen LE, Seaber AV, Urbaniak JR. Comparison of continuous and interrupted suture techniques in microvascular anastomosis. J Hand Surg Am 2001; 26 (03) 530-539
  • 19 Barros RSM, Leal RA, Teixeira RKC. et al. Continuous versus interrupted suture technique in microvascular anastomosis in rats. Acta Cir Bras 2017; 32 (09) 691-696