Complete Amputation of the Thigh, With Replantation

Carrel, A; Guthrie, C. C.

doi:10.1097/00000441-190602000-00013

Cited by 43 publications

(13 citation statements)

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“…Canines have been used in transplant research since the inception of the discipline, indeed the first published model of limb auto-transplantation was performed by Alexis Carrel using a dog in 1906 [33]. The first uses of immunosuppression in animal models of VCA were in canines in the 1960s and 1970s [6,7].…”

Section: Historical Perspectivesmentioning

confidence: 99%

“…There are strong similarities between the immune system of the human and other mammals, however it seems that the relatively longer exposure to allogens during the human lifespan causes adaptations in the immune response that are simply not present in animal species [33]. This problem is compounded by the fact that laboratory animals are typically immature when used in such investigations.…”

Section: Brief Immunological Considerationsmentioning

confidence: 99%

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Preclinical Models in Vascularized Composite Allotransplantation

2015

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Vascularized composite allotransplantation (VCA) has the potential to reconstruct any non-visceral tissue defect, using like for like tissue, delivering optimal form and function. Over 150 VCA transplants have been performed worldwide; however, this treatment remains experimental. Things systematically tried in the clinic should follow thorough science and tested in a model that allows predicting as possible the safety of the procedure. This is generally the function of animal experimentation. Advantages of preclinical models include greater control of bias, of subject numbers and of variables compared to clinical trials. Limitations include differences between species in anatomy and physiology as well as ethical, logistical and technical constraints. Multiple models have been described; however, no single model is ideal in all areas. This paper reviews historical perspectives, current models and future direction in VCA research.

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Section: Historical Perspectivesmentioning

confidence: 99%

Section: Brief Immunological Considerationsmentioning

confidence: 99%

Preclinical Models in Vascularized Composite Allotransplantation

2015

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“…[1][2][3][4] However, it was not until 1962 that Malt and Mckhann 5 first successfully replanted the arm of a 12-yearold boy. Five years later, in 1968, Komatsu and Tamai reported the first microsurgical replantation of a thumb.…”

mentioning

confidence: 99%

Long-Term Subjective and Functional Evaluation After Thumb Replantation With Special Attention to the Quick DASH Questionnaire and a Specially Designed Trauma Score Called Modified Mayo Score

Haas

Hubmer

Rappl

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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Functional results were independent of amputation level, length of ischemia, and patients age. Although sensory recovery and functional outcomes of the extrinsic muscle system were moderate, patients were able to use their thumb to perform work and daily living activities. The significant correlations of objective clinical tests and a mixed trauma score (modified Mayo score) with the Quick DASH allows the clinician to compare the postoperative result with the patient' functional competence in daily activities.

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“…He reported experimental autoreplantations of the hind limbs of dogs with survival from 1 to 9 days. Carrel and Guthrie (1906) described several attempts at replantation and transplantation of limbs as part of their pioneering work in vascular surgical technique. Reichert (1931) reported the results of 52 replantations of dog legs with primary vascular anastomoses with patency assessed by angiography and Hall (1944) speculated on the use of operative techniques for upper extremity replantation.…”

Section: History Of Replantationmentioning

confidence: 99%

Upper limb replantation

Lin

Jeng

Lin

et al. 2012

Trauma

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Since the first successful salvage of an amputated finger using microsurgical anastomoses in 1965, replantation has been widely used in these decades and is now firmly established as a viable treatment option in traumatic limb amputation. The current concepts of replantation surgery for upper limb amputation are discussed in this review article in terms of history of replantation, present indications for the procedure, pre-theater care, technical refinements, postoperative management and functional outcome. In this article, we demonstrated that the advent of microsurgery has led to replantation of almost every amputated part of the upper limb possible. Replantation of digits and the hand can restore not only circulation but also function and cosmetic appearance. However, major amputations remain a challenge and the functional outcome is often disappointing, albeit the success rate of replantation exceeds 80%. Proper patient selection, adequate pre-theater preservation, good operative skill and postoperative care, as well as tight cooperation among the patient, the surgeon, and the rehabilitation therapist will help to achieve a better final functional outcome.

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Complete Amputation of the Thigh, With Replantation

Cited by 43 publications

References 0 publications

Preclinical Models in Vascularized Composite Allotransplantation

Preclinical Models in Vascularized Composite Allotransplantation

Long-Term Subjective and Functional Evaluation After Thumb Replantation With Special Attention to the Quick DASH Questionnaire and a Specially Designed Trauma Score Called Modified Mayo Score

Upper limb replantation

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