This thesis examines the use of adhesives in the fabrication of microvascular anastomoses. Chapter 1 broadly examines the development, application and current practice of Microvascular Surgery. A historical review of vascular repair leads into a discusion of early and contemporary replantation and free tissue transfer operations. Chapter 2 focuses on the technical aspects of microvascular anastomosis. A review of the many techniques used is folowed by a description of the microvascular healing process. Chapter 3 reviews the use of surgical adhesives. The characteristics of an ideal surgical adhesive are set out. Previous work with surgical adhesives is discussed, and the composition, mode of action, application and fate of fibrinogen adhesive is described in detail. Chapter 4 describes a preliminary study in which a new adhesive microvascular anastomosis was developed. Using 6 rats and 12 rabbits an adhesive end-in-end technique was found to be easy to carry out and appeared to produce satisfactory vascular patency. A rabbit groin flap model was developed to test the new technique in a controlled manner. Chapter 5 describes an experimental study to test the new technique in 50 rabbits using 100 consecutive flaps. Each animal acted as its own control: one flap had a sutured anastomosis and one flap an adhesive anastomosis. Despite numerous technical differences between adhesive and sutured anastomoses, flap survival and patency rates were not significantly different, although adhesive anastomoses were faster and less difficult. The healing of the two types of anastomoses was compared and contrasted using histological sections and scanning electron microscopy. Chapter 6 examines the relevance of the adhesive technique to the contemporary Microvascular Surgeon, suggests other possible uses for fibrinogen adhesive in Microvascular Surgery, and speculates a little on future developments in this area of reconstructive surgery.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:641822 |
| Date | January 1991 |
| Creators | Bowen, Clifford Vaughan Alisby |
| Publisher | University of Edinburgh |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://hdl.handle.net/1842/23735 |
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