Effect of a combined oral contraceptive on patency of arterial anastomosis in a female rat model.

BACKGROUND: Oral contraceptives, which may lead to thrombotic events, are widely used drugs by women in reproductive age, some of whom might need emergent or elective microsurgical intervention. This study was planned to investigate the effects of combined oral contraceptives (COC) on arterial anastomosis patency in female rat model. METHODS: A third generation COC (ethinyl estradiol and desogestrel) was used in this study. A total of 50 female Wistar albino rats were included. The rats were divided into two groups. Experimental group received 0.03 mg ethinyl estradiol/0.15 mg desogestrel with gastric catheter for 20 days before the surgery. Afterward, the femoral arteries of all rats were divided and anastomosed. The patency of the anastomoses were assessed surgically (at 15 min, 7th day) and radiologically with Doppler ultrasonography (at 3rd and 7th days). The samples were examined using light microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). RESULTS: The early patency assessed in the 15th min showed arterial flow in all rats. But at the 7th day 68% of the anastomosis were patent in the COC group while 100% of the anastomosis were patent in the control group as demonstrated surgically and radiologically (P = 0.004). Microscopic examination showed an increase in cytoplasmic organelles and activation of endothelial cells in all rats in the experimental group that received COCs. CONCLUSION: The present study demonstrated the negative effects of the use of COCs on anastomosis patency in rats.

Calcaneal ulcer in a child with congenital insensitivity to pain syndrome.

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare hereditary sensory neuropathy, comprising congenital insensitivity to pain, anhidrosis, and mental retardation. We present a 4-year-old child with CIPA and a calcaneal ulcer who was treated with double opposing rotation flaps, which eventually healed.

Dorsal penile vein as a new training model for microvenous anastomosis in rats.

The authors present a new model for microsurgical training of venous anastomosis-namely, the dorsal penile vein of the rat. In 12 male Wistar rats weighing 220 to 290 g, the anatomy of the dorsal penile vein was studied by dissection and histology. Anatomic dissection studies revealed that the dorsal penile vein has an average diameter of 1.4 mm (range, 1.2-1.6 mm) without tendency to collapse. The vein could be dissected for an average segment of 25 mm without any branches, allowing easy dissection and approximator clamp placement. Comparison of its cross-section with that of the femoral vein histologically by light microscopy and scanning electron microscopy revealed a larger diameter and much thicker vessel wall with a prominent tunica media and adventitia. Based on the findings of the anatomic study, the dorsal penile vein anastomotic model was created in the rat. In 20 animals, the vein was divided sharply in its midsection and was anastomosed end-to-end using standard microsurgical technique. Results indicated a 100% patency rate immediately after the anastomosis and a 90% patency rate (18 of 20) 1 week after the procedure. This model offers the advantages of easy dissection without ligation of any side branches and a thick vessel wall without a tendency to collapse. Moreover, a major limb vein is not sacrificed. It is concluded that this new model may better simulate the clinical procedure of microvenous anastomosis because it presents similarities to human veins.