Less-suture Vascular Anastomosis: Development of Alternative Protocols with Multifunctional Self-wrapping, Transparent, Adhesive, Elastic Biomaterials.

Blood vessel anastomosis by suture is a life-saving, yet time-consuming and labor-intensive operation. While suture-less alternatives utilizing clips or related devices have been developed to address these shortcomings, suture anastomosis is still overwhelmingly used in most cases. In this study, we propose practical "less-suture" strategies, rather than ideal "suture-less" methods, to reflect real-world clinical situations. In the case of rat artery (d = 0.64 mm) anastomosis, the less-suture anastomosis involves the application of thin, adhesive, transparent, self-wrapping films to the site. This surprisingly reduced the number of stitches required from ten (without films) to four (with films), saving 27 minutes of operating time per vessel. Furthermore, the decreased number of stitches largely alleviated fibrosis-mediated wall-thickening. Thus, a less-suture strategy is particularly useful for anastomosis of multiple vessels in emergency conditions and small-diameter vessels. This article is protected by copyright. All rights reserved.