Acute adverse effects of blunt adventitial stripping

The adventitia is routinely removed from small arteries before the anastomosis, but the microcirculatory response to this maneuver has not been documented. We have used a rat cremaster muscle flap model for intravital microscopy to compare at the microcirculatory level the effect of blunt (n = 18) and sharp (n = 18) adventitial removal with unmanipulated control arteries (n = 18). Blunt stripping resulted in transient but significant reductions in the red cell velocity (50%, p < 0.05) and capillary perfusion (91%, p < 0.05). Sharp dissection did not affect red cell velocity; however, capillary perfusion was transiently reduced by 25% (p < 0.05). In this study, sharp adventitial dissection was found to be a less harmful method of small arteries preparation for microvascular anastomosis.