[Experimental study prevention of reperfusion injury of skeletal muscle by local hypothermia and its clinical application].
Local hypothermia as a preventive method to reperfusion injury of skeletal muscles was studied. Sixteen Japanese rabbits were divided into four groups at random. Before the tourniquet was inflated, a cold gel pack was applied to the right hind leg of each rabbit for 15 minutes to produce local hypothermic condition, without application of tourniquet the left hind limb was under local hypothermic condition as a control. The duration of tourniquet ischemia was 4 hours, and then reperfusion for one and two hours in the A and B groups respectively; in the C and D groups the duration of ischemia was 5 hours, and reperfusion for one and two hours, respectively. The muscle temperature averaged 16.6 degrees C with a needle thermocouple in the hind limb under local hypothermia. The serum K+, LA, SOD, LPO were determined from bilateral femoral veins, and electron and light microscopic studies of sural muscles were done in the post-reperfusion period. It was found that the K+, LA, LPO were lower than that of the control groups (P < 0.01), but SOD was higher than that of the control group (P < 0.01). Electron and light microscopic studies showed sight but reversible damage of muscular structure with the possibility of in the hypothermic groups cell regeneration. Basing on this experimental results, this method was applied in 45 cases reparative and reconstructive surgery of limbs. The duration of application of tourniquet averaged 2 hours and 57 minutes, the longest being 4 hours and 31 minutes, when the muscle temperature had reduced to 22.4 degrees C. There were no postoperative complications associated with this technique. Local hypothermia appeared to be a safe and effective method of decreasing the reperfusion damage after ischemia.
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Department of Orthopedic Surgery, First Hospital of Chongqing University of Medical Sciencie.
Jiang
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Ni
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D000293:Adolescent; D000328:Adult; D000818:Animals; D005121:Extremities / Q000601:surgery; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000648:ultrastructure*; D011183:Postoperative Complications / Q000517:prevention & control; D011817:Rabbits; D011897:Random Allocation; D015427:Reperfusion Injury / Q000517:prevention & control*; D012881:Skin Temperature; D013997:Time Factors; D014111:Tourniquets