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J Reconstr Microsurg 2024; 40(04): 245-252
DOI: 10.1055/a-2153-2467
Original Article

Rat Microvascular Model is Tolerant to Technical Errors

Joseph R. Paladino   *
1   Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
,
YuanDian Zheng   *
1   Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
,
Konstantinos Gasteratos
2   Harley Street Clinic, London, UK
,
John J. Corvi 
1   Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
,
Katherine H. Park
1   Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
,
Yelena Akelina
1   Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York
› Author Affiliations Funding The project was sponsored by an educational grant from the Orthopedic Scientific Research Foundation.
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Abstract

Background Extensive studies have been conducted using the rat model to understand the potential technical errors that lead to anastomotic failure. However, current literature indicates that the rat model has excellent tolerance to diverse errors committed by microsurgeons. The error-investigating rat model is often created by one or two experienced surgeons, and only one isolated technical error is examined. These biases may potentially cause limitations of the results from previous studies. Meanwhile, venous anastomoses have rarely been investigated in previous literature. Therefore, it is important to elucidate this topic with a more comprehensive study design.

Methods Ninety-four arterial and 94 venous anastomoses on Sprague–Dawley rat femoral vessels that were performed by 47 microsurgeons who participated in the microsurgery course at the Columbia University and the University of Thessaloniki were evaluated. In total, 10 technical errors were examined: (1) disruption of suture line, (2) back-wall stitch, (3) oblique stitch, (4) wide bite, (5) partial thickness bite, (6) unequal suture distance, (7) tear in vessel wall, (8) excessively tight suture, (9) suture threads in lumen, and (10) large edge overlap. The frequency of each error committed, and the 30-minute postoperative patency was also recorded. The underlying causal relationship between these errors, potential interaction, and the short-term anastomosis patency was analyzed statistically.

Results Only the back-wall stitch was found to have a significant causal effect on arterial anastomosis failure (p < 0.001). Back-wall stitch, wide bite, and partial thickness bite significantly impact venous anastomosis patency (p < 0.001). No other statistically significant result was found.

Conclusion Overall, the rat model is highly resilient to various technical errors despite these mistakes being often considered clinically unacceptable. Therefore, researchers need to consider the resilience of the rat model when designing and analyzing future studies. In addition, microsurgery instructors should focus on individual stitch quality rather than the final patency.

Keywords

microsurgery training - microsurgery errors - rat model in microsurgery

Note

This study was presented at the Plastic Surgery The Meeting 2021 in Atlanta, Georgia.[29]


* These authors contributed equally to this work.


Supplementary Material



Publication History

Received: 06 May 2023

Accepted: 13 July 2023

Accepted Manuscript online:
14 August 2023

Article published online:
26 September 2023

© 2023. Thieme. All rights reserved.

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