allopurinol and Crush-Syndrome

We report our results using University of Wisconsin (UW) cold storage solution in two cases of major replantation of the upper extremity. We employed a technique of a complete vascular washout with 1000 ml UW solution at 4 degrees Celsius at 120 cm hydrostatic pressure into the artery via a size 18 cannula. The ischaemic time of the amputated limbs were 7 hours and 11 1/4 hours respectively. No fasciotomy was performed upon revascularisation and minimal swelling was observed postoperatively. No post-ischaemic syndrome was encountered following the replantation surgery. With a follow-up of 10 and 16 months respectively, muscle and nerve viability were observed with sensory recovery and motor reinnervation. There was absence of muscle contracture and at subsequent surgical procedures, healthy musculature was present in the replanted limbs. These two clinical cases suggest that the UW solution has a role in extending the duration of tissue preservation and improving the quality of the tissues preserved.

Topics: Adenosine; Allopurinol; Amputation, Traumatic; Anastomosis, Surgical; Arm Injuries; Crush Syndrome; Cryopreservation; Debridement; Follow-Up Studies; Forearm Injuries; Glutathione; Humans; Insulin; Male; Motor Neurons; Nerve Regeneration; Organ Preservation Solutions; Postoperative Complications; Raffinose; Replantation; Wound Healing