Microsurgery
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Several types of nerve conduits have been used for peripheral nerve gap bridging. This study investigated the in vivo engineering of a biological nerve conduit and its suitability for nerve gap bridging. ⋯ The in vivo engineered conduits allow nerve gap bridging of 15 mm. However, quality of regeneration after 4 weeks observation time is not comparable to autologous nerve grafts. Whether biogenic conduits might be a suitable alternative to artificial and biological conduits for gap bridging will have to be evaluated in further studies.
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Microvascular anastomotic coupling devices have been available to microsurgeons for over 20 years. Many studies have validated the efficacy of these devices for venous anastomosis. To date, there have been no large reports of their success in the anatomical region with the highest free flap failure rate, the lower extremity. ⋯ Microvascular anastomotic coupling devices create effective venous anastomoses in lower extremity microvascular reconstruction. Thus, it presents an important tool in the armamentarium for lower extremity microsurgical reconstruction.