Pedicled Vascularized Lymph Node Transfer Treats Lymphedema in Rat Hind Limb: A Simple Experimental Study Design

Vascularized lymph node transfer is a new and promising technique for the physiologic treatment of lymphedema and several clinical and experimental studies have been conducted in recent years. However, the exact mechanism of vascularized lymph node transfer is still unknown. In this study, we aimed to investigate treatment efficacy through the design of a simple and feasible experimental lymphedema model for testing a vascularized lymph node transfer technique. After a pilot study, 30 male Sprague-Dawley rats were divided into two groups and lymphedema was induced in the hindlimb of both groups. In Group 1 (control, n=15) no treatment was applied while pedicled lymph node transfer was applied in Group 2 (experimental, n=15). Model dynamics were assessed with lymphoscintigraphy, limb measurement, and histological analysis. A statistically significant limb circumference reduction at the ankle was seen on days 30 and 90 in Group 2 as compared to Group 1, p<0.05, and lymphatic tracer transport improved in 13 out of the 15 animals in Group 2. A statistically significant reduction in histological scores was achieved in Group 2, p<0.05. In this rat hindlimb lymphedema model, our vascularized lymph node transfer technique is an effective physiologic surgical treatment and represents a feasible experimental model for future studies.

Investigation of venous drainage patterns of rabbit peripheral nerves

In this study, the venous drainage patterns of white New Zealand rabbits' peripheral nerves were examined in an effort to provide an animal model for studies focusing on the venous drainage of the healing nerves. Extremities of rabbits sacrificed via intraarterial lead oxide-gelatin solution, and thus had their peripheral bloods pushed out of the arteries and into the veins were dissected for the venous drainage of radial, median, ulnar, femoral, sciatic, tibial and fibular nerves. The observations revealed that white New Zealand rabbit was a feasible model due to its consistent venous anatomy draining the major nerves and accessibility and workability of them. Of those dissected, the most suitable set of nerves suitable for such studies seem to be the Median nerve of the anterior extremity, and Sciatic nerve of the posterior extremity (Fig. 12, Ref. 16). Text in PDF www.elis.sk. Text in PDF www.elis.sk.

Barcelona consensus on supermicrosurgery

The popularity of supermicrosurgery has increased dramatically over the past few years, but the lack of agreement regarding the name of the technique and its applications has caused misunderstandings among microsurgeons when trying to communicate and compare surgical procedures. We report the consensus reached on the name used to refer to supermicrosurgery techniques following the First European Conference on Supramicrosurgery held in Barcelona (Spain) on March 4-5, 2010. Present applications, advantages, and disadvantages of supermicrosurgery are discussed. It was agreed that supermicrosurgery was the most accurate name to reflect the essence of this extremely delicate technique. According to Koshima, supermicrosurgery is a technique of microneurovascular anastomosis for vessels of 0.3 to 0.8 mm and single nerve fascicles. The range of applications for this technique has increased rapidly and now includes lymphedema treatment, nerve reconstruction, replantation and reconstruction of amputated fingertips, microsurgical flap salvage, and new possibilities for free tissue transfer. Supermicrosurgery is a remarkably useful reconstructive tool that involves a great deal of skill and has a steep learning curve for the microsurgeon to master. Although it is currently performed by only a minority of microsurgeons, we consider it will be incorporated into conventional microsurgery in the near future.