Evaluation of BioGlue surgical adhesive for the performance of microsurgical arterial anastomoses: impact on the flow of vessels greater than 1 mm (rat aorta) and less than 1 mm (rat femoral)

Abstract

Objective. Despite the recent advances and innovations in the field of microsurgery and free flaps, vascular anastomoses are still manual and surgeon dependent with traditional methods. The purpose of this study is to evaluate the effectiveness, in the short and medium-term, of glutaraldehyde with bovine serum albumin (BSA) surgical adhesive in the performance of arterial microanastomoses.Material and methods. Fourteen femoral end to end anastomoses (Group 1) and 10 aortic anastomoses (Group 2) were performed in 18 Wistar rats. Flux was measured before, immediately after the anastomoses, and 24 hours later, with a transit-time ultrasound to have quantitative data. Anastomoses technique consisted in using minimal stitches to approximate the vessels and applying BioGlue® adhesive to seal the union. The SSPS® package was used for the statistical study.Results. A median of 2 stitches were necessary in femoral arteries, and 4 stitches in aorta. The median anastomoses time was 16.5 minutes in Group 1 and 32.5 in Group 2. 93% anastomoses of Group 1 and 100% in Group 2, were permeable immediately, and 77% in Group 1 and 100% in Group 2 were permeable after 24 hours, with adequate flux measures. There were no differences in pre and postanastomotic – 24 h aorta-diameter.Conclusions. The use of glutaraldehyde with BSA is a promising technique for the microsurgery of the future, and it is a fast, easy, and reliable alternative to perform microvascular anastomoses, especially when surgeon needs to avoid repeated trauma in the vessel wall or wants to reduce the material inside the lumen and reduce the risk of thrombosis.