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AKDENİZ DOĞAN, ZEYNEP DENİZ

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AKDENİZ DOĞAN

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ZEYNEP DENİZ

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    Comparing Venous Thrombosis Rates in Hand-Sewn Anastomosis to Anastomotic Coupler Devices
    (WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2021) SAÇAK, BÜLENT; Dogan, Zeynep Akdeniz; Aydin, Cem; Cavus-Ozkan, Melekber; Sacak, Bulent; Bayramicli, Mehmet
    Background: Anastomotic coupling device (ACD) has reached wide popularity, especially in venous anastomosis of free-tissue transfers. There are scant reviews in the literature about the reliability of these devices in venous anastomosis. We retrospectively analyzed our free flap cases to compare the thrombosis rates between ACDs and handsewn anastomosis and other possible risk factors that may contribute to venous thrombosis. Materials and Methods: Data of all microvascular free-tissue transfers performed between January 2015 and August 2019 were retrospectively reviewed. Patient characteristics were recorded. Reconstruction characteristics such as venous anastomosis type (hand-sewn vs. anastomotic coupler device), reconstruction site, and number of surgical interventions were also recorded. Results: A total of 385 consecutive-free microvascular reconstructions were identified. Total venous thrombosis rate was 4.7%. There was no statistically significant difference between hand-sewn anastomosis and anastomosis with coupler device (5.2% vs. 3.2%, P = 0.58). Only reconstruction site was found to be significantly associated with higher venous thrombosis (P = 0.03). Discussion: Our results involving different reconstruction sites and including multiple flap types demonstrated comparable revision rates between ACDs and hand-sewn anastomosis. This finding is consistent with the current literature.
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    The Efficacy of Hydrodilatation for the Prevention of Vasospasm following Microsurgical Anastomosis
    (THIEME MEDICAL PUBL INC) BAYRAMİÇLİ, MEHMET NURİ ÜMİT; Serin, Merdan; Bayramicli, Mehmet; Cilingir Kaya, Ozlem Tugce; Levent, Hilal Nisva; Akdeniz Dogan, Zeynep Deniz; Ercan, Alp; Kurt Yazar, Sevgi
    Introduction Vasospasm is a major problem following microsurgical reconstruction which can result in the partial or complete loss of the flap tissue. The aim of this study was to investigate the efficiency of hydrodilatation for the prevention of vasospasm. Material and Methods Thirty male Wistar rats were used for this experimental study. Femoral arteries of were exposed, photographed, and transected. In group 1, group 2, and group 3 papaverine solution, hydrodilatation, and minimal mechanical dilatation (control group) was performed, respectively. The anastomosis was completed and the arteries were photographed again 10minutes after completion of the anastomosis. Following 7-day period samples for transmission electron microscopy (TEM) and light microscopy were obtained. Results The mean vessel diameters prior to transection were 0.43, 0.45, and 0.52mm in the papaverine, hydrodilatation, and control groups, respectively. The mean vessel diameter 10minutes following the completion of anastomosis was 0.76, 0.75, and 0.51mm in the papaverine, hydrodilatation, and control groups, respectively. Median score for papaverine group regarding histological parameters of regular endothelial lining and lumen, neutrophil infiltration, vascular congestion, and edema in tunica adventitia was 2, 3, 2, and 3 positive, respectively. Median score for the papaverine group regarding histological parameters of regular endothelial lining and lumen, neutrophil infiltration, vascular congestion, and edema in tunica adventitia was 3, 3, 3, and 3 positive, respectively. All the histological scores were negative in the control group. The difference between the control group and the experiment groups 1 and 2 was significant regarding all four histological parameters ( p <0.05). Conclusion Hydrodilatation and papaverine application were both effective in preventing vasospasm following microsurgical intervention but papaverine caused slightly less damage to the endothelial lining and less edema in the tunica adventitia when compared with the hydrodilatation. Hydrodilatation group showed a vasodilatory effect that was statistically similar to that of papaverine, which has a proven efficacy.