Inverted (Buried) Reef Knot in Microsurgery - A Technical Note

Özet

In side to side anastomosis and end to end (one way up) microvascular anastomosis, the back wall of the vessel is sutured first withinverted/buried knots. A common mistake made by surgeons during this step is the formation of a granny knot. In inverted suturing,cut ends of granny knot points inside the vessel lumen and interfere with the suture line. This additional Intraluminal thread maypromote foreign body reaction and may act as a nidus for thrombus formation. Hence, this subtle mistake in knot formation maycause immediate and/or delayed anastomosis failure. The purpose of the study was to describe principles of inverted/buried reefknot formation. We describe in detail the methodology to form an inverted reef knot in microsurgery using paracords and a glovemodel.