LETTER TO THE EDITOR
MICROSURGERY 00:00–00 (2014)
A NOVEL “CONTINUOUS-INTERRUPTED” METHOD FOR MICROVASCULAR ANASTOMOSIS Dear Editor,
breaking. In addition, if it happens to be left inside the lumen, the crush point could be thrombogenic.
I read with great interest the article by Sapountzis et al.1 entitled “A novel “continuous-interrupted” method for microvascular anastomosis.” First, I appreciate that the authors have correctly described this method for microvascular anastomosis as “continuous-interrupted.” As a user of this method for over 20 years, I have witnessed that the key to perform a successful anastomosis with this method is to set up the loops neatly. We start the end-to-end anastomosis from the top (0 ) by placing a suture, continuous to the bottom (180 ), along the front side of the vessel walls. When making ties, we gently push the loops toward the bottom, so we can easily make individual ties from the top. After finishing the front side, we then rotate the vessel, so we can suture the back wall while exercising the same techniques. This time, we go from 180 to 360 . However, there are two minor disadvantages with this approach due to the frequent stretching of the surgical sutures, which eventually breaks the delicate threads. By pulling on the sutures, we create crush points on them, which weaken its structure and make it susceptible to
*Correspondence to: Chun-Heng Wang, No.139, Ping Tien Street, Taichung, Taiwan. E-mail: [email protected]
Received 11 March 2014; Accepted 24 March 2014 Published online 00 Month 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/micr.22255 Ó 2014 Wiley Periodicals, Inc.
CHING-YUEH WEI Department of Plastic and Reconstructive Surgery Cheng Ching General Hospital Taichung, Taiwan CHUN-HENG WANG Department of Anesthesiology Cheng Ching General Hospital Taichung, Taiwan
The authors gratefully thank Nathan Wei for the assistance of editing this article.
REFERENCE 1. Sapountzis S, Kiranantawat K, Lim SY, Constantinides J, Ciudad P, Nicoli F, Wei MYS, Sonmez TT, Chen HC. A novel “continuousinterrupted” method for microvascular anastomosis. Microsurgery 2014;34:82–84.