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Effect of fluoro carbon perfusion for amputated limb preservation effect of inhibition for replantation toxemia and muscle tissue destruction



Effect of fluoro carbon perfusion for amputated limb preservation effect of inhibition for replantation toxemia and muscle tissue destruction



Journal of the Japanese Orthopaedic Association 58(5): 497-508



It is widely accepted that replantation toxemia or muscle destruction in replanted limbs might occur after a long period of ischemia. This is more probable after replantation of amputated limbs which contain more muscle than tendon and bones. This study was performed to investigate the efficacy of fluorocarbon (FC: artificial blood) perfusion to the amputated limbs in preventing these problems after replantation. The hind limbs of dogs were completely amputated at mid-thigh. Amputated limbs were divided into 2 groups. One was stored in ice water and the other at room temperature for 6 h. Each group was furthermore divided into 4 subgroups. The amputated limbs were perfused with oxygenated FC or Hartmann's solution before replantation, and remaining limbs were not perfused. All of them were replanted under an operating microscope. The results were as follows: perfusion with FC had an inhibiting effect on the anaerobic metabolism in an amputated limb and also decreased the rate of death due to replantation toxemia; perfusion with FC was effective for inhibiting leakage of creatinine phosphokinase from the replanted limb and preventing muscle destruction, as detected biochemically and histologically; the reactive hyperemia of the replanted limb usually occurred after replantation, but was significantly decreased after replantation of the amputated limb perfused with FC. The effects described above were more remarkable when the amputated limb was perfused continuously rather than intermittently. Thus, for prevention of systemic ill effects after replantation and for preservation of function of the amputated limb, continuous perfusion with FC in ice water is more effective than ice water cooling alone.

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Accession: 005239601

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