Indian Journal of Plastic Surgery
An open access publication of Association of Plastic Surgeons of India
Users Online: 575  
Home | Subscribe | Feedback | Login 
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2192    
    Printed159    
    Emailed1    
    PDF Downloaded98    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

 

 ORIGINAL ARTICLE
Year : 2009  |  Volume : 42  |  Issue : 2  |  Page : 146--149

Effect of surgical traumas on microcirculation


Department of Plastic Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh-221005, India

Correspondence Address:
Visweswar Bhattacharya
Department of Plastic Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh-221005
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-0358.59271

Rights and Permissions

Background: Adequate microcirculation in different tissues maintains the physiological function and heals surgical wounds. In any surgical procedure, the commonly used instruments are cautery, tissue forceps, and clamps. The fact that their inappropriate use produces an adverse effect on microcirculation is often not realized. By this study, we could demonstrate live, the effect of these surgical traumas. Methods: The study was conducted on the inferiorly based fasciocutaneous flap with a fascial extension in patients with a distal leg defect. The extended fascial flap was mounted on a glass slide and observed for live microcirculation under x160 magnification. Three methods were used: (a) cautery in low power, (b) microcrushing forceps to crush the vessels, and (c) noncrushing clamps at the base of the fascial flap. Results: It was observed that the vessels are well protected within the deep fascia. Once the fascia was pierced the current damaged the vessel wall. As the wattage was increased, it caused charring of the tissue and multiple vessels ultimately leading to cessation of blood flow. Once the vessel wall was crushed by forceps, blood extravasated in a variable intensity depending upon the size of the vessel. Clamping led to gradual slowing of blood flow with microclot formation. In certain vessels, there was discontinuity in the blood column and ultimately the blood flow stopped. Conclusion: This study showed live demonstration of the effect of surgical traumas on microcirculation. It should guide the surgeons to select the use of appropriate instruments which will cause minimal damage to vascularity and thereby lead to a better surgical outcome.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Site Map  |  Home  |  Contact Us  |  Feedback  |  Copyright and Disclaimer
Online since 11th March '04
Published by Wolters Kluwer - Medknow