Journal of reconstructive microsurgery
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Medicinal leeches are widely used to treat venous congestion in microvascular surgery. Aeromonas hydrophila infection, following application of the leech species Hirudo medicinalis, is a recognized complication. Administration of antibiotics directed at Aeromonas has been successful in minimizing complications of infection from this organism. ⋯ A study of the enteric content of 30 of these leeches showed that Aeromonas hydrophila was isolated in only 20 percent of animals, while the majority of remaining positive cultures were single and mixed gram-negative rods. All organisms isolated were sensitive to current recommended coverage for Aeromonas hydrophila. This study suggests that the enteric flora of different leech species may be variable and should be carefully characterized, to direct appropriate prophylactic therapy prior to release of new species for clinical use.
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J Reconstr Microsurg · Jan 1994
The effect of pentoxifylline on ischemia and reperfusion injury in the rat cremaster muscle.
The accumulation of leukocytes is believed to contribute to reperfusion injury following ischemia. The purpose of this study was to determine if pentoxifylline (PTX) would ameliorate reperfusion injury by preventing activation of leukocytes. Male Wistar rats received 40 mg/kg of PTX orally in water for 6 days, and a single dose of PTX (30 mg/kg) intraarterially before experiments. ⋯ There were no significant differences in arteriolar diameter or density of flowing capillaries between the two groups at any time. Treatment with PTX prevented accumulation of rolling and sticking leukocytes following reperfusion. This may contribute to the improved arteriolar blood flow following 2 hr of ischemia.
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J Reconstr Microsurg · Nov 1993
Clinical TrialDouble vascularized fibulas for reconstruction of large tibial defects.
Vascularized fibular grafts have proven to have many advantages over nonvascularized transplants for treatment of large segmental bone defects in the extremities. Fibulas are typically impacted into the medullary canal and fixed with wires or screws. Consolidation has often been delayed and full weightbearing was only possible after graft hypertrophy, usually 12 to 18 months after reconstruction. ⋯ In six patients, healing was uneventful. In one patient, hypoperfusion of the lower extremity and the vascularized grafts eventually resulted in a below-knee amputation. In all six successful cases, union resulted within 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Reconstr Microsurg · Nov 1993
Vascularized nerve tube: an experimental alternative for vascularized nerve grafts over short gaps.
Multilayered tubes fabricated from human amnion were placed subcutaneously and/or longitudinally in contact with an axial artery and vein in rats. Histologic evaluation at the third postoperative week showed that the tubes had incorporated with the surrounding fibrovascular tissue. New capillary formation within the tube wall was well demonstrated by microangiography. ⋯ After 3 months, nerve regeneration was assessed using morphometric analysis. The vascularized amnion conduits showed comparable nerve regeneration to vascularized nerve grafts (p > 0.05), and superior nerve regeneration when compared to nonvascularized amnion conduits and nonvascularized nerve grafts as well (p < 0.05). This suggests that, in the rat model, a conduit can be neovascularized and used as a prefabricated tissue, to bridge short nerve gaps in a compromised bed.
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J Reconstr Microsurg · Mar 1993
Case Reports Comparative StudyA technique for nerve reconstruction following resection of soft-tissue sarcoma.
Primary nerve grafting should be considered whenever tumor extirpation necessitates resection of an adjacent critical nerve. A technique of nerve grafting is presented which distinguishes motor from sensory fascicles, using intraoperative electrical stimulation. ⋯ Motor and silent sensory fascicles are tagged prior to tumor resection. This facilitates subsequent specific motor/sensory reconstruction of the defect, using intrafascicular grafting techniques.