The fate of venous repair after shock and trauma.
To assess the role of shock and trauma in the subsequent thrombosis of a venous repair, the following experiments were performed. Two groups of unsplenectomized dogs were studied: control dogs (Gr.C) underwent replacement of a segment of superficial femoral vein by an autogenous vein graft. Trauma group (Gr.T) dogs were subjected to hypovolemic shock using a modified Wiggers' technique and received standardized hindleg trauma. After resuscitation, venous repairs identical to Gr.C dogs were performed. Gr.T dogs exhibited a 78% thrombosis rate as opposed to 12% in Gr.C animals. To elucidate possible mechanisms, platelets were drawn from another ten animals, divided into similar groups, and labelled with Indium111-oxine. In Gr.T animals, graft activity increased over time and platelet distribution along the graft was homogeneous. These results contrasted markedly with those of Gr.C animals. We conclude that shock and trauma predispose venous repairs to failure and that altered platelet-endothelium interactions may be implicated.
Department of Surgery, Montreal General Hospital, Quebec, Canada.
J S
JS
Barkun
O
O
Terazza
P
P
Daignault
R C
RC
Chiu
D S
DS
Mulder
D000818:Animals; D001792:Blood Platelets / Q000502:physiology; D001794:Blood Pressure; D004285:Dogs; D005268:Femoral Vein / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000209:etiology*; D007205:Indium Radioisotopes; D011183:Postoperative Complications; D012151:Resuscitation; D012769:Shock / Q000097:blood / Q000150:complications*; D013924:Thrombophlebitis / Q000209:etiology*; D014947:Wounds and Injuries / Q000150:complications*
D007205:Indium Radioisotopes