Tourniquet-induced ischemia and reperfusion in subcutaneous tissue, skeletal muscle, and calcaneal cancellous bone.
Aged
Calcaneus
/ metabolism
Cancellous Bone
/ metabolism
Female
Foot Deformities, Acquired
/ surgery
Humans
Male
Middle Aged
Muscle, Skeletal
/ metabolism
Orthopedic Procedures
/ adverse effects
Prospective Studies
Reperfusion Injury
/ etiology
Subcutaneous Tissue
/ metabolism
Tourniquets
/ adverse effects
Bone
ischemic metabolites
microdialysis
soft tissues
tourniquet
Journal
APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
ISSN: 1600-0463
Titre abrégé: APMIS
Pays: Denmark
ID NLM: 8803400
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
27
11
2020
accepted:
21
01
2021
pubmed:
27
1
2021
medline:
27
3
2021
entrez:
26
1
2021
Statut:
ppublish
Résumé
This study aimed to evaluated ischemic metabolites in subcutaneous tissue, skeletal muscle, and calcaneal cancellous bone before, during, and after tourniquet application in a simultaneous paired comparison of tourniquet-exposed and non-tourniquet-exposed legs. Ten patients scheduled for hallux valgus or hallux rigidus surgery were included. Microdialysis catheters were placed to simultaneously and continuously sample the metabolites glucose, lactate, pyruvate, and glycerol bilaterally for 12 h in subcutaneous tissue, skeletal muscle, and calcaneal cancellous bone. A tourniquet was applied on the leg planned for surgery (inflation time: 15 min, mean tourniquet duration time (range): 65 (58;77) min). During tourniquet inflation, a 2- to 3-fold increase of the mean lactate/pyruvate ratio was found for all investigated tissues in the tourniquet-exposed leg compared with the non-tourniquet-exposed leg. The lactate/pyruvate ratio recovery time after tourniquet release was within 30 min for skeletal muscle, 60 min for subcutaneous tissue, and 130 min for calcaneal cancellous bone. Only the tourniquet-exposed skeletal muscles were found to be ischemic during tourniquet inflation, defined by a significant increase of the lactate/pyruvate ratio exceeding the ischemic cutoff level of 25; however, this level decreased below 25 immediately after tourniquet release. The glycerol ratio increased instantly after inflation in the tourniquet-exposed leg in skeletal muscle and subcutaneous tissue, and recovered within 60 (skeletal muscle) and 130 min (subcutaneous tissue) after tourniquet release. These findings suggest that applying tourniquet for approximately 1 h results in limited tissue ischemia and cell damage in subcutaneous tissue, skeletal muscle, and calcaneal cancellous bone.
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
225-231Subventions
Organisme : Health Research Foundation of Central Denmark Region
Organisme : Elisabeth og Karl Ejnar Nis-Hansens Mindelegat Foundation
Organisme : Laege Sofus Carl Emil Friis og Hustru Olga Doris Friis' legat Foundation
Organisme : Augustinus Foundation
Organisme : A. P. Møller Foundation
Organisme : Familien Hede Nielsen Foundation
Informations de copyright
© 2021 Scandinavian Societies for Medical Microbiology and Pathology.
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