Hand Replantation is not Adversely Affected by Prior Ice Immersion: The Physiological Role of Ice in the Transport of Amputated Limbs

  • Harnarayan P
  • Seepaul T
  • Lalla R
  • Islam S.
Cite this:
[1]
Harnarayan P, Seepaul T, Lalla R, and Islam S., “Hand Replantation is not Adversely Affected by Prior Ice Immersion: The Physiological Role of Ice in the Transport of Amputated Limbs ”, ijmhs, vol. 12, no. 05, pp. 1892–1897, May 2022.
© 2022 Interactive Protocols
RIGHTS & PERMISSIONS
Article Views
221
Altmetric
1
Citations
-
LEARN ABOUT THESE METRICS
   PDF  

Abstract

Background: One of the most challenging operations in reconstructive surgery is the replanting of an amputated hand. Instituted protocols for the transport of the limb to hospital exist to allow it to remain cooled and therefore salvageable to the surgical team for replantation. This paper looks at limb preservation prior to replantation with the transport medium being analysed to see how it relates to the existing evidence on limb cooling. Methods:Three cases of hand amputation werereferred forreplantation with two cases transported in ice arriving at hospital in a viable state without icicle formation nor maceration of the tissue. One wastransported neither in a plastic container placed in ice nor directly in ice.All three underwent replantation, two being the dominant hands. Results: The outcomes of three cases were matched with the method of transport used for each limb. The two limbs which were transported in ice were replanted with veryfavorable short and long-term outcomes. The other hand initially appeared to be viable but intrinsic hand muscle necrosis lead to a poor outcome. Conclusion The significant change that occurs during cooling has been experimentally shown to be alkalinization of muscle cells which offsets the deadly effects acidosis, produced by muscle ischemia, has on the muscle cells. This and not the drop in metabolic activity due to the temperature drop,causes tissue preservation prior to and during replantation.Direct immersion on ice is therefore not a contraindication to surgical repair.

KEYWORDS:

 Special Issue

Article Metrics Graph

Chart Graph | Range Graph

Content

Section

Source

License

All paper submissions must carry the following duly signed by all the authors:
“I certify that I have participated sufficiently in the conception and design of this work and the analysis of the data (wherever applicable), as well as the writing of the manuscript, to take public responsibility for it. I believe the manuscript represents valid work. I have reviewed the final version of the manuscript and approve it for publication. Neither has the manuscript nor one with substantially similar content under my authorship been published nor is being considered for publication elsewhere, except as described in an attachment. Furthermore I attest that I shall produce the data upon which the manuscript is based for examination by the editors or their assignees, if requested.”