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A novel suction device for microsurgery
Innervation of three weight-bearing areas of the foot 26. Chang KN, Buncke HJ. Sensory reinnervation in reconstruction of foot. Foot Ankle 1986;7:124e32. 27. Masquelet AC, Romana MC, Wolf G. Skin island flaps supplied by the vascular axis of the sensitive superficial nerves. Anatomic study and clinical experience in the leg. Plast Reconstr Surg 1992;89:1115e21. 28. May JW, Rohrich RJ. Foot reconstruction using free microvascular muscle flaps with skin grafts. Clin Plast Surg 1986;13: 681e9.
561 29. Mathes SJ, Nahai F. Reconstructive Surgery Principles Anatomy and Technique, vol. 2. Philadelphia: Churchill Livingstone; 1997. 30. Eils E, Nolte S, Tewes M, et al. Modified pressure distribution patterns in walking following reduction of plantar sensation. J Biomech 2002;35:1307e13. 31. Tanz SS. Heel pain. Clin Orthop Relat Res 1963;28:169e78. 32. Sallick MA, Blum L. Sensory denervation of the heel for persistent pain following fractures of the calcaneus. J Bone Joint Surg 1948;30(A):209e12.
SURGICAL TIP A novel suction device for microsurgery Many trainees and consultants often encounter problems, particularly out of hours, in obtaining fine, effective suction devices for their microsurgical cases. In our unit, we have overcome this difficulty by using a novel, inexpensive device, composed of readily available theatre equipment. This ‘microsuction device’ involves placing the standard Yanker suction tubing inside a 5 ml syringe and a 24 gauge paediatric cannula at the tip of the syringe itself (Fig. 1). We have found that this device compares favourably with other similar methods.1e3 The simple design is such that in scenarios where clot or debris blocks the suction device, one can
simply change the cannula to a larger bore cannula quickly and rapidly, avoiding the need to stop the microsurgical anastomosis to replace or unblock the sucker, as would normally occur with standard suction devices. Furthermore, we have found that this device is quite atraumatic to vessels and, hence, one can safely use it without fear of contact trauma to the vessel wall itself. The placement of a hole using a large bore needle in the 5 ml syringe distal to the Yanker sucker facilitates even finer control of the strength of suction with simple on/ off finger control. We have found that this simple modification works very effectively as a fine sucker in all microsurgical scenarios. We recommend this to others as an inexpensive, easily constructed and readily available device for use in their microsurgical reconstructions.
References 1. Beckenstein MS, Windle BH. A new suction device for microsurgery. J Reconstr Microsurg 1996 Feb;12(2):127e8. 2. Clifford JR, Frederic J. A continuous suction device for maintaining a dry microsurgical field. J Microsurg 1980 Dec; 2(2):147. 3. Menovsky T, De Vrie J. Atraumatic suction tip for microsurgery: technical note. Microsurgery 2004;24(4):302e3.
Figure 1 Novel microsurgical suction device, consisting of Yanker suction tubing inside a 5 ml syringe with a 24 gauge paediatric cannula at the syringe tip. Note the hole in the syringe distal to the Yanker sucker which facilitates fine control of suction strength (black arrow).
Robert H.Caulfield Niri S.Niranjan St Andrew’s Centre for Burns & Plastic Surgery, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK E-mail address: [email protected] ª 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2007.09.040
561 29. Mathes SJ, Nahai F. Reconstructive Surgery Principles Anatomy and Technique, vol. 2. Philadelphia: Churchill Livingstone; 1997. 30. Eils E, Nolte S, Tewes M, et al. Modified pressure distribution patterns in walking following reduction of plantar sensation. J Biomech 2002;35:1307e13. 31. Tanz SS. Heel pain. Clin Orthop Relat Res 1963;28:169e78. 32. Sallick MA, Blum L. Sensory denervation of the heel for persistent pain following fractures of the calcaneus. J Bone Joint Surg 1948;30(A):209e12.
SURGICAL TIP A novel suction device for microsurgery Many trainees and consultants often encounter problems, particularly out of hours, in obtaining fine, effective suction devices for their microsurgical cases. In our unit, we have overcome this difficulty by using a novel, inexpensive device, composed of readily available theatre equipment. This ‘microsuction device’ involves placing the standard Yanker suction tubing inside a 5 ml syringe and a 24 gauge paediatric cannula at the tip of the syringe itself (Fig. 1). We have found that this device compares favourably with other similar methods.1e3 The simple design is such that in scenarios where clot or debris blocks the suction device, one can
simply change the cannula to a larger bore cannula quickly and rapidly, avoiding the need to stop the microsurgical anastomosis to replace or unblock the sucker, as would normally occur with standard suction devices. Furthermore, we have found that this device is quite atraumatic to vessels and, hence, one can safely use it without fear of contact trauma to the vessel wall itself. The placement of a hole using a large bore needle in the 5 ml syringe distal to the Yanker sucker facilitates even finer control of the strength of suction with simple on/ off finger control. We have found that this simple modification works very effectively as a fine sucker in all microsurgical scenarios. We recommend this to others as an inexpensive, easily constructed and readily available device for use in their microsurgical reconstructions.
References 1. Beckenstein MS, Windle BH. A new suction device for microsurgery. J Reconstr Microsurg 1996 Feb;12(2):127e8. 2. Clifford JR, Frederic J. A continuous suction device for maintaining a dry microsurgical field. J Microsurg 1980 Dec; 2(2):147. 3. Menovsky T, De Vrie J. Atraumatic suction tip for microsurgery: technical note. Microsurgery 2004;24(4):302e3.
Figure 1 Novel microsurgical suction device, consisting of Yanker suction tubing inside a 5 ml syringe with a 24 gauge paediatric cannula at the syringe tip. Note the hole in the syringe distal to the Yanker sucker which facilitates fine control of suction strength (black arrow).
Robert H.Caulfield Niri S.Niranjan St Andrew’s Centre for Burns & Plastic Surgery, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK E-mail address: [email protected] ª 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2007.09.040