A comparative study of the use of 9-0 PDS and 9-0 prolene in microvascular anastomosis.

9-0 absorbable polydioxanone (PDS) has been compared to 9-0 nonabsorbable Prolene in order to evaluate any advantages of either suture in microvascular surgery. In each of 29 rats, one carotid artery was anastomosed end-to-end with PDS and the other with Prolene. Specimens were harvested 48 hr, 14 days, and three, and five months postoperatively. Histologic examination of the carotids followed postmortem using 4.5 x magnification angiography. Histologic analysis of inflammation, fibrosis, and medical necrosis of the anastomoses revealed no significant differences between the two materials. There was no difference as regards stenosis and aneurysm formation, when evaluated independently by the two methods. It was observed that saccular aneurysms formed as a result of medial necrosis and could develop at any time. Fusiform aneurysms formed where the media was replaced by bulging fibrosis and they appeared late. External support of adherent skeletal muscle prevented aneurysm formation. It can be concluded that the amount of inflammation and fibrosis leading to stenosis is related to the amount of trauma at the time of surgery and not to the type of suturing material used.