CLINICS

Clinics (Sao Paulo). 2017 September; 72(9): 538-542.
doi:10.6061/clinics/2017(09)03

Copyright © 2017 CLINICS

Experimental study of histological changes in vascular loops according to the duration of the postoperative period: Application in reconstructive microsurgery

Renata Gregorio Paulos * , Bruno Alves Rudelli , Renee Zon Filippe , Gustavo Bispo dos Santos , Ana Abarca Herrera , Andre Araujo Ribeiro , Marcelo Rosa de Rezende , Teng Hsiang-Wei , Rames Mattar

Departamento de Ortopedia e Traumatologia, Instituto de Ortopedia e Traumatologia (IOT), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR

*Corresponding author. E-mail: renata.paulos@hc.fm.usp.br

received December 19, 2016; revised May 10, 2017; accepted May 10, 2017.

Abstract

OBJECTIVES:

To analyze the histological changes observed in venous grafts subjected to arterial blood flow as a function of the duration of the postoperative period to optimize their use in free flap reconstructions.

METHOD:

Twenty-five rats (7 females and 18 males) underwent surgery. Surgeries were performed on one animal per week. Five weeks after the first surgery, the same five animals were subjected to an additional surgery to assess the presence or absence of blood flow through the vascular loop, and samples were collected for histological analysis. This cycle was performed five times.

RESULTS:

Of the rats euthanized four to five weeks after the first surgery, no blood flow was observed through the graft in 80% of the cases. In the group euthanized three weeks after the first surgery, no blood flow was observed in 20% of the cases. In the groups euthanized one to two weeks after the first surgery, blood flow through the vascular loop was observed in all animals. Moreover, intimal proliferation tended to increase with the duration of the postoperative period. Two weeks after surgery, intimal proliferation increased slightly, whereas strong intimal proliferation was observed in all rats evaluated five weeks after surgery.

CONCLUSION:

Intimal proliferation was the most significant change noted in venous grafts as a function of the duration of the postoperative period and was directly correlated with graft occlusion. In cases in which vascular loops are required during free flap reconstruction, both procedures should preferably be performed during the same surgery.

Keywords: Vascular Loop, Intimal Hyperplasia, Vascular Remodeling


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