Abstract
CONTINUOUS VERSUS INTERMITTENT SUTURE TECHNIQUE IN VASCULAR ANASTOMOSIS IN CASES OF PERIPHERAL VASCULAR TRAUMA

Niranjan Ulhasrao Jadhav, *Ajit Kumar Padhy, Madhur Kumar, Khushwant Popli, Farhan Khan, Anubhav Gupta

ABSTRACT

Objective: We in this study have aimed to compare the continuous vascular anastomosis technique with the intermittent vascular anastomosis in peripheral vascular trauma and to see if the difference with respect to luminal patency, clinical outcome, limb salvagibility. Methods: Thirty patients with peripheral vascular trauma who met the inclusion criteria during study period (September 2019- August 2020) were included. Data was analysed by categorizing all study subjects into continuous and intermittent anastomosis group. Results: Amongst 30 patients studied, the mean age at the time of presentation was 25.3 ± 5years with youngest patient of 1.5yrs and eldest being 48 years old. 12 (40%) underwent reverse interposition vein grafting from contralateral limb due to segment loss. Intermittent suture technique for anastomosis was done in 53.4 %(n=16) cases, while 46.6% (n = 14) underwent continuous suture technique. Post operative Doppler study revealed triphasic, biphasic and monophasic/no flow in operated vessel in 24, 2 and 4 respectively. Out of the four patients who had monophasic flow, three were seen in continuous and one in intermittent suture technique. Amputation was performed in 3 patients who underwent continuous suturing technique, while only one case of intermittent technique group underwent amputation. No mortality or re-explorations were noted in the study population. Conclusion: Luminal patency was seen to be better in intermittent technique, operative time was seen less in case of continous suturing group although the added complications cannot be kept unseen. Surgeon preference, comfort to surroundings and available modality affect the choice of anastomosis done. More human based studies are the need of the hour.

Keywords: Outcomes; Vascular trauma; vascular anastomosis; continuous; intermittent; limb salvage; Amputation.


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