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BACKGROUND: The vascular endothelial growth factor (VEGF) plays an important role in the development and formation of blood vessels. Up to now, there are few reports about the treatment of postoperative complications of vascular anastomosis surgery by mcrosutures with VEGF in China. OBJECTIVE: To synthesiize microsutures with VEGF and to evaluate its effect in revascularization following small vessel anastomosis. METHODS: The method of emulsification-diffusion was use to produce biodegradable polymer polylactic acid/glycolic acid (PLGA) copolymer microparticles containing VEGF, and then, the microparticles were added into microsutures to prepare microsutures with VEGF. Ninety Sprague-Dawley rats were enrolled to make animal models of caudal artery anastomosis using microsutures with VEGF in experimental group and microsutures alone in control group. Complications and VEGF level in the peripheral blood were detected and hematoxylin-eosin staining at the anastomotic site was performed at 2, 12 hours, 1, 3, 7 days after anastomosis. RESULTS AND CONCLUSION: (1) Postoperative complications: The postoperative incidence of skin necrosis was significantly lower in the experimental group than the control group (P < 0.05). (2) VEGF level: Compared with the control group, the peripheral blood VEGF level was significantly higher in the experimental group at each time point after operation (P < 0.05). (3) Hematoxylin-eosin staining: In the experimental group, proliferated endothelial cells were seen near the anastomotic site at 1 day after anastomosis; there were a large number of proliferated endothelial cells and subcutaneous tissues covering the sutures completely at 3 days after anastomosis; and endothelial cells and internal elastic lamina were completely repaired, smooth muscle cells proliferated further, and the outer membrane returned to normal at 1 week after anastomosis. In the control group, cell degeneration and necrosis were seen near the anastomotic suture, and only adventitial cells infiltrated and exhibited a traumatic proliferative response at 1 day after anastomosis; neonatal endothelial cells appeared in the exfoliated area of the endothelial cells, grew and migrated, and there was a few endothelial cells covering the anastomotic site at 3 days after anastomosis; and newborn endothelial cells got over the anastomotic crack and covered the suture. To conclude, microsutures with sustained-release VEGF microparticles can promote endothelial cell regeneration in rats at the anastomotic site. [ABSTRACT FROM AUTHOR]