Autogenous micro-arterial grafts to the femoral vein in rabbits.
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Animals↗
Biomedical subjects
G N Threlfall
Publications and source records attributed to G N Threlfall.
Microvascular second toe transfer for digital reconstruction.
Reconstruction of a severely damaged hand, with multiple amputations of digits, presents a difficult reconstructive problem. The development of a safe method of transfer of the great toe for thumb reconstruction, using the dorsalis pedis artery and the saphenous vein, suggested the possibility of one-stage microvascular transfer of the second toe for reconstruction of fingers. In two patients a one-stage transfer of the second toe was done to replace an index finger and in another for restoration of part of the left ring finger. The transplants survived without anticoagulants and vessel complications were not encountered. Sensory return was adequate and a significant improvement in function was achieved.
Accidents, Occupational↗
Experimental micro-anastomosis of 0.4-0.5 mm vessels.
Ninety-two anastomoses of arteries 0.5 mm in diameter have been performed in rats with an 85-90 per cent patency rate in the second postoperative week. The factors of prime importance in the achievement of high patency rates have been atraumatic handing and meticulous suturing technique. At 1 hour and at 8 to 10 days the patency rates were not statistically different whether 20 per cent magnesium sulphate heparin or normal saline were used. Similar results were obtained with 40 repairs of divided veins averaging 0.4 mm in diameter. These results suggest strongly that clinical microvascular surgery in vessels approximately 0.5 mm in diameter, especially in children, should given results comparable to 1 mm vessel surgery.
Animals↗
Microlymphaticovenous anastomoses for obstructive lymphedema.
Microlymphatic surgery appears to have a worthwhile clinical application in the treatment of secondary obstructive lymphedema. We prefer 3 or more lymphaticovenous anastomoses at, or above, the elbow; otherwise ablative procedures are recommended. In the selected cases there are some advantages of anastomoses over surgical reduction procedures: (1) the incidence of postoperative cellulitis is significantly less; (2) the microlymphatic techniques are applicable to both upper and lower limbs and perhaps could be extended to localized cases of obstructive lymphedema following trauma and congenital constriction bands. Considerable experience in microvascular surgery is required for doing this type of work. A long-term evaluation of the results of microlymphatic surgery in obstructive secondary lymphedema is required before judging its potential--especially in view of the fluctuating history of lymphedema--but the results reported are encouraging.
Adult↗