Abstract
Authors proposed a simple innovative technique that helps in achieving a clear surgical field at the time of venous repair by diverting the venous bleeding through a glove finger and at the same time preventing venous congestion of the flap.
Highlights
DISCUSSIONIn micro-vascular surgery, there is no consensus regarding which vessel to be repaired first - the artery or the vein
If the second vein is clamped, venous congestion develops, which is well known to be detrimental to flap survival [2]
We introduce the second vena comitans into one end of a cut glove finger rinsed with heparinised saline [5000 I.U. of heparin in 500 ml saline] to divert the bleeding from the operative field
Summary
In micro-vascular surgery, there is no consensus regarding which vessel to be repaired first - the artery or the vein. Repair of the artery first has the advantage of early flap revascularization and reducing the warm ischemia time. The disadvantage of repairing the artery first is that, if the artery is unclamped after the anastomosis, bleeding from the second vena comitans makes the repair of vein difficult. If the venous anastomosis is performed first, it delays revascularization of the flap. The aim of our innovative idea is to divert the bleeding from the freely draining vena comitans away from the venous anastomosis site. We tried an innovative technique using the finger of a surgical glove to divert venous blood from the second vena comitans away from the surgical field
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