The occurrence of ischemia reperfusion injury during limb replantation surgery will lead to tissue edema, increasing bone compartment pressure and compressing vascular nerve, and even cause muscle necrosis, infection, or limb necrosis.
In clinical work, we found that the swelling degree of muscle which received fasciotomy after reperfusion was obviously higher than fasciotomy performed before reperfusion in limb replantation. Partial limb's muscle even cannot be sutured because of severe muscle swelling when fasciotomy was performed after reperfusion.
The concept of limb replantation
is credited to William Halsted, an American surgeon who "transplanted the hind leg of a dog from one side to the other" in 1887 but did not report it until 1922.
Major limb replantation
and postischemia syndrome: Investigation of acute ischemia-induced myopathy and reperfusion injury.
Microsurgery today is applied to a variety of medical operations ranging from limb replantation
to coronary artery bypass procedures.
A preliminary report of tissue preservation with University of Wisconsin cold storage solution in major limb replantation. Ann Acad Med Singapore 1995 Jul;24(4)(Suppl):37-41.
published one of the largest review regarding major limb replantations, they stated that 22 of 24 patients were satisfied with the function and appearance of their replanted part.
Following upper limb replantation
, rapid development of osteopenia has been reported in the bones of the hand in all cases.
The experimental studies on animals have shown that histological changes in the tissues, which had ischemia, were detected only in early period after limb replantation
. In the remote period after replantation there were detected histological changes specific to denervated tissues (Povslen et al., 1995; Moras and Berger, 2003).
(5) In 1887, Halsted began experiments on limb replantation
, (6) and in 1906, Carrel and Guthrie described the first successful canine limb replantation
In 1887, Halsted began experiments on limb replantation
. (1) In 1906, Carrel and Guthrie described the first successful canine limb replantation
, and Carrel outlined his techniques for vascular repair the following year.