Recent progress in microvascular surgery has opened a new clinical era in tissue transplantation and replantation by the direct anastomoses of vessels less than 1 mm in external diameter. However, in spite of continous training and the use of improved microscope, instruments, and suture, it is still difficult to obtain patency rates of 90percent.
Acland, has demonstrated that topical magnesium sulfate helps prevent small vessel thrombosis by its strong antiplatelet agglutination and vasodilation effect. However, as he has pointed out , the presence of manesium sulfate causes prolonged and severe bleeding from the gaps in the suture line. Therefore, I have used silicone cuff to splint the suture line and reduce the bleeding caused by magnesium sulfate. Tubes of 1.3mm internal diameters were used and a 4mm length of the tube was then split longitudinally and applied around the suture line, before removal of the vascular clamps.
In the experiment, forty Sprague-Dawley rats, weighing 250 to 300 gm, were divided into 4 equal groups.
A femoral artery in each was repaired, using magnesium sulfate and the silicone cuff in Group 1 and omitting them in Group 2. a femoral vein in each was repaired, using magnesium sulfate and the silicone cuff in Group 3 and omitting them in Group 4. Ten anastomoses were done in each group.
Re-exploration were carried out after 3 weeks after the operation. In Group 1, 100 percent, and in Group 2, 90 percent had patent arterial anastomossis. For the veins, 100 percent of Group 3 and 70 percent of Group 4 had remained patent.
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