[机械血管吻合]

IF 1 4区 医学 Q3 ORTHOPEDICS Operative Orthopadie Und Traumatologie Pub Date : 2024-12-01 Epub Date: 2024-11-06 DOI:10.1007/s00064-024-00868-4
P Pour Farid, A Arkudas, Raymund E Horch
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引用次数: 0

摘要

背景:血管机械吻合是现代外科手术的一大进步。高度专业化的器械可确保血管的精确连接,从而立即恢复血流。特别是用于静脉吻合的环形耦合器系统,因其方便性和可靠性已在临床实践中得到证明,现已成为外科手术中不可或缺的一部分:目标:精确且功能正常的血管吻合;缩短吻合时间;最大限度地减少受影响组织的灌注障碍;减少术中和术后并发症:适应症:截肢和受伤后的肢体再植;使用游离皮瓣进行缺损重建;显微外科血管旁路手术:禁忌症:严重的血管病变,如血管动脉瘤、动脉硬化或吻合部位有严重炎症;血管管腔之间差异较大;血管过小或过大:手术技巧:夹紧血管两端;根据血管直径选择合适的环状耦合器尺寸;在血管两端至少各移动 1 厘米;耦合器装置的功能测试;穿刺血管,牢固连接环状装置并移除固定装置;移除夹钳,检查吻合口:术后管理:定期检查血液循环;避免吻合口受压;充分抗凝:结果:吻合精确;手术时间缩短。
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[Mechanical vascular anastomoses].

Background: Mechanical anastomoses of blood vessels represent a major advance in modern surgery. Highly specialized instruments ensure the precise connection of blood vessels, enabling the immediate restoration of blood flow. Ring coupler systems for venous anastomoses, in particular, have proven themselves in clinical practice due to their convenience and reliability and are now an indispensable part of surgical routines.

Objectives: Precise and functionally proper anastomosis of blood vessels; shortening of the anastomosis time; minimization of perfusion disorders in the affected tissue; reduction of intraoperative and postoperative complications.

Indications: Replantation of extremities after amputations and injuries; defect reconstruction using free flaps; microsurgical vascular bypass procedures.

Contraindications: Severe vascular pathologies such as vascular aneurysms, arteriosclerosis or severe inflammation in the area of the anastomosis; large differences between the vessel lumina; too small or too large vessels.

Surgical technique: Clamping of both vessel ends; selection of the appropriate ring coupler size based on the vessel diameter; mobilization of at least 1 cm at each vessel end; functional testing of the coupler device; threading the vessels, securely joining the rings and removing the holding device; removing clamps, inspection of the anastomosis.

Postoperative management: Regular blood circulation checks; avoiding pressure on the anastomosis; adequate anticoagulation.

Results: Precise anastomoses; reduction in operating time.

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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
32
审稿时长
>12 weeks
期刊介绍: Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care. The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems. Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.
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