关键词: 吻合术, 外科, 上肢, 动脉损伤

Abstract:

Objective：To investigate the outcomes of applying microvascular anastomotic coupling devices in solitary upper extremity artery injury repairs and to optimize parameters for optimal clinical outcome. Methods: From March to September 2013, 19 injured arteries from 18 male patients who  presented at Department of Hand Surgery, Beijing Jishuitan Hospital with traumatic arterial lacerations of their upper extremities went through rapid repair procedures. COUPLER, a microvascular anastomotic coupling device was applied in these artery injury repair operations. The 19 repaired arteries included 3 brachial arteries, 6 ulnar arteries and 10 radial arteries. After the procedures, all the 18 patients were then followed up by clinical specialists and examined with color doppler flow imaging for the effective recovery of artery circulation and upper extremities functionality.  Results: The average time of artery repairs for all the 19 damaged arteries among the 18 patients was 278 s and the average follow-up time was (71.5±40.9) d with the longest follow-up time as 116 d and shortest as 14 d. No patient returned to the opera-ting room after the procedures and after being dismissed from the hospital. None of the 18 cases were reported to have problems with circulation and thrombosis formation in their upper extremities. Color Doppler imaging showed that the arterial anastomotic site for all the 19 repaired arteries were unobstructed with artery blood spectrum at both ends. Three patients with radial artery repairs complained about mild pressure pain at the site of vascular anastomosis; while the other 15 patients all expressed satisfactory outcomes of the surgery and recovery. These evidences indicated that the outcomes of our initial evaluation for the solitary upper extremity artery injury repairs by using anastomotic coupling devices were positive. Conclusion: Our observations have showed that microvascular anastomotic coupling devices can be used for repairing of solitary upper extremity artery injures. The procedures are quick, effective and safe. The clinical application of this microvascular anastomotic coupling device in artery injures is promising, however, additional evidences through further clinical investigation with more cases are warranted.

Key words: Anastomosis, surgical, Upper extremity, Artery injure