RESEARCH PROGRESS OF SEVERED LIMB PRESERVATION BY PERFUSION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

QINXinyuan ¹ , ZHANGShaochun ² , GAOLei ² , YINYefeng ² , LIUNing ² ,  WANGJiangning ²

1. Graduate School of Capital Medical University, Beijing, 100069, P. R. China;
2. Department of Reparative and Reconstructive Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100069, P. R. China;

Corresponding author：

WANGJiangning, Email: doctorjnwang@163.com

Keywords：

Severed limb preservation; Perfusion; Ischemia-reperfusion injury

DOI：

10.7507/1002-1892.20140228

Video：

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Objective To summarize the research progress of severed limb preservation by perfusion and to analyze difference in effect of severed limb preservation by different perfusate. Methods The domestic and foreign related literature about severed limb preservation by perfusion was extensively reviewed and analyzed. Results Currently the main perfusate includes organ perfusate,free radical scavengers,energy mixture,blood substitutes,and whole blood.They can reduce the skeletal muscle's ischemia-reperfusion injury in different degrees. Conclusion Different perfusate can reduce the skeletal muscle's ischemia-reperfusion injury in different degrees,but the best effect of perfusate and personalized preservation method need further study.

Citation： QINXinyuan, ZHANGShaochun, GAOLei, YINYefeng, LIUNing, WANGJiangning. RESEARCH PROGRESS OF SEVERED LIMB PRESERVATION BY PERFUSION. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(8): 1047-1050. doi: 10.7507/1002-1892.20140228 Copy

1.	Gordon L,Levinsohn DG,Borowsky CD,et al.Improved preservation of skeletal muscle in amputated limbs using pulsatile hypothermic perfusion with University of Wisconsin solution.A preliminary study.J Bone Joint Surg (Am),1992,74(9):1358-1366.
2.	Kour AK,Phone MH,Chia J,et al.A preliminary report of tissue preservation with University of Wisconsin cold storage solution in major limb replantation.Ann Acad Med Singapore,1995,24(4Suppl):37-41.
3.	Wagh M,Pantazi G,Romeo R,et al.Cold storage of rat skeletal muscle free flaps and pre-ischemic perfusion with modified UW solution.Microsurgery,2000,20(7):343-349.
4.	Tsuchida T,Kato T,Yamaga M,et al.Effect of perfusion during ischemia on skeletal muscle.J Surg Res,2001,101(2):238-241.
5.	Tsuchida T,Kato T,Yamaga M,et al.The effect of perfusion with UW solution on the skeletal muscle and vascular endothelial exocrine function in rat hindlimbs.J Surg Res,2003,110(1):266-271.
6.	van der Heijden EP,Kroese AB,Werker PM,et al.Improving the preservation of isolated rat skeletal muscles stored for 16 hours at 4 degrees C.Transplantation,2000,69(7):1310-1322.
7.	王洪刚,刘小林,李智勇.UW液动脉预灌洗对缺血肢体再灌注损伤的影响.中山大学学报:医学科学版,2013,34(6):856-860.
8.	王建枝,殷莲华.病理生理学.8版.北京:人民卫生出版社,2013:142-145.
9.	Silvestro A,Scopacasa F,Oliva G,et al.Vitamin C prevents endothelial dysfunction induced by acute exercise in patients with intermittent claudication.Atherosclerosis,2002,165(2):277-283.
10.	Yan J,Tie G,Messina LM.Tetrahydrobiopterin,L-arginine and vitamin C act synergistically to decrease oxidant stress and increase nitricoxide that increases blood flow recovery after hindlimb ischemia in the rat.Mol Med,2012,18:1221-1230.
11.	赵克然,杨毅军,曹道俊.氧自由基与临床.北京:中国医药科技出版社,2000:19.
12.	Verkerk A,Jongkind JF.Vascular cells under peroxide induced oxidative stress:a balance study on in vitro peroxide handling by vascular endothelial and smooth muscle cells.Free Radic Res Commun,1992,17(2):121-132.
13.	李继峰,顾玉东,袁伟,等.超氧化物歧化酶灌注对断肢血管平滑肌和骨骼肌的保护作用.中华手外科杂志,1997,13(1):49-52.
14.	Rocca M,Giavaresi G,Caliceti P,et al.Pathophysiological and histomorphological evaluation of polyacryloylmorpholine vs polyethylene glycol modified superoxide dismutase in a rat model of ischaemia/reperfusion injury.Int J Artif Organs,1996,19(12):730-734.
15.	Giardino R,Giavaresi G,Fini M,et al.The role of different chemical modifications of superoxide dismutase in preventing a prolonged muscular ischemia/reperfusion injury.Artif Cells Blood Substit Immobil Biotechnol,2002,30(3):189-198.
16.	范里,杜飞,刘世清,等.丹参对肢体缺血再灌注损伤保护的实验研究.中国中医骨伤科杂志,2003,11(5):9-11.
17.	陈建常,史振满,王乐农,等.丹参对缺血肢体关节软骨及滑膜损伤的影响.骨与关节损伤杂志,2000,15(2):121-122.
18.	Tóth Š Jr,Pekárová T,Varga J,,et al.Intravenous administration of tetramethylpyrazine reduces intestinal ischemia-reperfusion injury in rats.Am J Chin Med,2013,41(4):817-829.
19.	陈雷,金可可,潘景业,等.葛根素对家兔肢体缺血再灌注后心脏功能的保护作用.中国中西医结合外科杂志,2006,12(3):260-263.
20.	顾玉东,李继峰,袁伟,等.离断肢体血管与肌肉保护的实验研究.中华创伤杂志,1996,12(1):2-5.
21.	刘晓钟,陈忠勇,洪士东.低温能量合剂持续灌注在超时断肢再植中的应用.中华手外科杂志,1999,15(2):84.
22.	章伟文,李学渊,陈宏,等.能量合剂灌注对人离体骨骼肌超微结构的影响.现代实用医学,2007,19(1):50-51.
23.	Sakata H.An experimental study of the effect of fluorocarbon perfusion for amputated limb preservation.The effect of inhibition for replantation toxemia and muscle tissue destruction.Nihon Seikeigeka Gakkai Zasshi,1984,58(5):497-508.
24.	Takahashi F.An experimental study on the effect of fluorocarbon perfusion for the preservation of an amputated limb.Nihon Seikeigeka Gakkai Zasshi,1987,61(10):1123-1134.
25.	Smith AR,van Alphen B,Faithfull NS,et al.Limb preservation in replantation surgery.Plast Reconstr Surg,1985,75(2):227-237.
26.	Xu S,Wang P,Wei K,et al.Cytoprotection of perfluorocarbon on PMVECs in vitro.Inflammation,2013,36(2):512-520.
27.	Delorme TL,Shaw RS,Austen WG.A method of studying "normal" function in the amputated human limb using perfusion.J Bone Joint Surg (Am),1964,46:161-164.
28.	Domingo-Pech J,Garriga JM,Toran N,et al.Preservation of the amputated canine hind limb by extracorporeal perfusion.Int Orthop,1991,15(4):289-291.
29.	Constantinescu MA,Knall E,Xu X,et al.Preservation of amputated extremities by extracorporeal blood perfusion; a feasibility study in a porcine model.J Surg Res,2011,171(1):291-299.
30.	Müller S,Constantinescu MA,Kiermeir DM,et al.Ischemia/reperfusion injury of porcine limbs after extracorporeal perfusion.J Surg Res,2013,181(1):170-182.
31.	尹叶锋,王江宁,高磊,等.不同温度对体外模拟体内生理环境寄养断肢系统的影响研究.中国修复重建外科杂志,2013,27(1):72-76.
32.	黄慕康,于仲嘉,王澍寰,等.对断肢(指)再植若干问题的讨论.中华显微外科杂志,1994,17(1):48-67.
33.	Lloyd MS,Teo TC,Pickford MA,et al.Preoperative management of the amputated limb.Emerg Med J,2005,22(7):478-480.

1. Gordon L,Levinsohn DG,Borowsky CD,et al.Improved preservation of skeletal muscle in amputated limbs using pulsatile hypothermic perfusion with University of Wisconsin solution.A preliminary study.J Bone Joint Surg (Am),1992,74(9):1358-1366.
2. Kour AK,Phone MH,Chia J,et al.A preliminary report of tissue preservation with University of Wisconsin cold storage solution in major limb replantation.Ann Acad Med Singapore,1995,24(4Suppl):37-41.
3. Wagh M,Pantazi G,Romeo R,et al.Cold storage of rat skeletal muscle free flaps and pre-ischemic perfusion with modified UW solution.Microsurgery,2000,20(7):343-349.
4. Tsuchida T,Kato T,Yamaga M,et al.Effect of perfusion during ischemia on skeletal muscle.J Surg Res,2001,101(2):238-241.
5. Tsuchida T,Kato T,Yamaga M,et al.The effect of perfusion with UW solution on the skeletal muscle and vascular endothelial exocrine function in rat hindlimbs.J Surg Res,2003,110(1):266-271.
6. van der Heijden EP,Kroese AB,Werker PM,et al.Improving the preservation of isolated rat skeletal muscles stored for 16 hours at 4 degrees C.Transplantation,2000,69(7):1310-1322.
7. 王洪刚,刘小林,李智勇.UW液动脉预灌洗对缺血肢体再灌注损伤的影响.中山大学学报:医学科学版,2013,34(6):856-860.
8. 王建枝,殷莲华.病理生理学.8版.北京:人民卫生出版社,2013:142-145.
9. Silvestro A,Scopacasa F,Oliva G,et al.Vitamin C prevents endothelial dysfunction induced by acute exercise in patients with intermittent claudication.Atherosclerosis,2002,165(2):277-283.
10. Yan J,Tie G,Messina LM.Tetrahydrobiopterin,L-arginine and vitamin C act synergistically to decrease oxidant stress and increase nitricoxide that increases blood flow recovery after hindlimb ischemia in the rat.Mol Med,2012,18:1221-1230.
11. 赵克然,杨毅军,曹道俊.氧自由基与临床.北京:中国医药科技出版社,2000:19.
12. Verkerk A,Jongkind JF.Vascular cells under peroxide induced oxidative stress:a balance study on in vitro peroxide handling by vascular endothelial and smooth muscle cells.Free Radic Res Commun,1992,17(2):121-132.
13. 李继峰,顾玉东,袁伟,等.超氧化物歧化酶灌注对断肢血管平滑肌和骨骼肌的保护作用.中华手外科杂志,1997,13(1):49-52.
14. Rocca M,Giavaresi G,Caliceti P,et al.Pathophysiological and histomorphological evaluation of polyacryloylmorpholine vs polyethylene glycol modified superoxide dismutase in a rat model of ischaemia/reperfusion injury.Int J Artif Organs,1996,19(12):730-734.
15. Giardino R,Giavaresi G,Fini M,et al.The role of different chemical modifications of superoxide dismutase in preventing a prolonged muscular ischemia/reperfusion injury.Artif Cells Blood Substit Immobil Biotechnol,2002,30(3):189-198.
16. 范里,杜飞,刘世清,等.丹参对肢体缺血再灌注损伤保护的实验研究.中国中医骨伤科杂志,2003,11(5):9-11.
17. 陈建常,史振满,王乐农,等.丹参对缺血肢体关节软骨及滑膜损伤的影响.骨与关节损伤杂志,2000,15(2):121-122.
18. Tóth Š Jr,Pekárová T,Varga J,,et al.Intravenous administration of tetramethylpyrazine reduces intestinal ischemia-reperfusion injury in rats.Am J Chin Med,2013,41(4):817-829.
19. 陈雷,金可可,潘景业,等.葛根素对家兔肢体缺血再灌注后心脏功能的保护作用.中国中西医结合外科杂志,2006,12(3):260-263.
20. 顾玉东,李继峰,袁伟,等.离断肢体血管与肌肉保护的实验研究.中华创伤杂志,1996,12(1):2-5.
21. 刘晓钟,陈忠勇,洪士东.低温能量合剂持续灌注在超时断肢再植中的应用.中华手外科杂志,1999,15(2):84.
22. 章伟文,李学渊,陈宏,等.能量合剂灌注对人离体骨骼肌超微结构的影响.现代实用医学,2007,19(1):50-51.
23. Sakata H.An experimental study of the effect of fluorocarbon perfusion for amputated limb preservation.The effect of inhibition for replantation toxemia and muscle tissue destruction.Nihon Seikeigeka Gakkai Zasshi,1984,58(5):497-508.
24. Takahashi F.An experimental study on the effect of fluorocarbon perfusion for the preservation of an amputated limb.Nihon Seikeigeka Gakkai Zasshi,1987,61(10):1123-1134.
25. Smith AR,van Alphen B,Faithfull NS,et al.Limb preservation in replantation surgery.Plast Reconstr Surg,1985,75(2):227-237.
26. Xu S,Wang P,Wei K,et al.Cytoprotection of perfluorocarbon on PMVECs in vitro.Inflammation,2013,36(2):512-520.
27. Delorme TL,Shaw RS,Austen WG.A method of studying "normal" function in the amputated human limb using perfusion.J Bone Joint Surg (Am),1964,46:161-164.
28. Domingo-Pech J,Garriga JM,Toran N,et al.Preservation of the amputated canine hind limb by extracorporeal perfusion.Int Orthop,1991,15(4):289-291.
29. Constantinescu MA,Knall E,Xu X,et al.Preservation of amputated extremities by extracorporeal blood perfusion; a feasibility study in a porcine model.J Surg Res,2011,171(1):291-299.
30. Müller S,Constantinescu MA,Kiermeir DM,et al.Ischemia/reperfusion injury of porcine limbs after extracorporeal perfusion.J Surg Res,2013,181(1):170-182.
31. 尹叶锋,王江宁,高磊,等.不同温度对体外模拟体内生理环境寄养断肢系统的影响研究.中国修复重建外科杂志,2013,27(1):72-76.
32. 黄慕康,于仲嘉,王澍寰,等.对断肢(指)再植若干问题的讨论.中华显微外科杂志,1994,17(1):48-67.
33. Lloyd MS,Teo TC,Pickford MA,et al.Preoperative management of the amputated limb.Emerg Med J,2005,22(7):478-480.

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