Plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage.
Military literature has demonstrated the utility and safety of tourniquets in preventing mortality for some time, paving the way for increased use of tourniquets in civilian settings, including perioperatively to provide a bloodless surgical field. However, tourniquet use is not without risk and the...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0244236 |
| _version_ | 1811342306276540416 |
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| author | Emily Busse Cheryl Hickey Nicole Vasilakos Kennon Stewart Fred O'Brien Jessica Rivera Luis Marrero Michelle Lacey Rebecca Schroll Keith Van Meter Mimi C Sammarco |
| author_facet | Emily Busse Cheryl Hickey Nicole Vasilakos Kennon Stewart Fred O'Brien Jessica Rivera Luis Marrero Michelle Lacey Rebecca Schroll Keith Van Meter Mimi C Sammarco |
| author_sort | Emily Busse |
| collection | DOAJ |
| description | Military literature has demonstrated the utility and safety of tourniquets in preventing mortality for some time, paving the way for increased use of tourniquets in civilian settings, including perioperatively to provide a bloodless surgical field. However, tourniquet use is not without risk and the subsequent effects of tissue ischemia can impede downstream rehabilitative efforts to regenerate and salvage nerve, muscle, tissue and bone in the limb. Limb ischemia studies in both the mouse and pig models have indicated not only that there is residual flow past the tourniquet by means of microcirculation, but also that recovery from tissue ischemia is dependent upon this microcirculation. Here we expand upon these previous studies using portable Near-Infrared Imaging to quantify residual plasma flow distal to the tourniquet in mice, pigs, and humans and leverage this flow to show that plasma can be supersaturated with oxygen to reduce intracellular hypoxia and promote tissue salvage following tourniquet placement. Our findings provide a mechanism of delivery for the application of oxygen, tissue preservation solutions, and anti-microbial agents prior to tourniquet release to improve postoperative recovery. In the current environment of increased tourniquet use, techniques which promote distal tissue preservation and limb salvage rates are crucial. |
| first_indexed | 2024-04-13T19:09:15Z |
| format | Article |
| id | doaj.art-73403a5e5a8d4ed9a88ed17ec0b4abcd |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T19:09:15Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-73403a5e5a8d4ed9a88ed17ec0b4abcd2022-12-22T02:33:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011512e024423610.1371/journal.pone.0244236Plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage.Emily BusseCheryl HickeyNicole VasilakosKennon StewartFred O'BrienJessica RiveraLuis MarreroMichelle LaceyRebecca SchrollKeith Van MeterMimi C SammarcoMilitary literature has demonstrated the utility and safety of tourniquets in preventing mortality for some time, paving the way for increased use of tourniquets in civilian settings, including perioperatively to provide a bloodless surgical field. However, tourniquet use is not without risk and the subsequent effects of tissue ischemia can impede downstream rehabilitative efforts to regenerate and salvage nerve, muscle, tissue and bone in the limb. Limb ischemia studies in both the mouse and pig models have indicated not only that there is residual flow past the tourniquet by means of microcirculation, but also that recovery from tissue ischemia is dependent upon this microcirculation. Here we expand upon these previous studies using portable Near-Infrared Imaging to quantify residual plasma flow distal to the tourniquet in mice, pigs, and humans and leverage this flow to show that plasma can be supersaturated with oxygen to reduce intracellular hypoxia and promote tissue salvage following tourniquet placement. Our findings provide a mechanism of delivery for the application of oxygen, tissue preservation solutions, and anti-microbial agents prior to tourniquet release to improve postoperative recovery. In the current environment of increased tourniquet use, techniques which promote distal tissue preservation and limb salvage rates are crucial.https://doi.org/10.1371/journal.pone.0244236 |
| spellingShingle | Emily Busse Cheryl Hickey Nicole Vasilakos Kennon Stewart Fred O'Brien Jessica Rivera Luis Marrero Michelle Lacey Rebecca Schroll Keith Van Meter Mimi C Sammarco Plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage. PLoS ONE |
| title | Plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage. |
| title_full | Plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage. |
| title_fullStr | Plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage. |
| title_full_unstemmed | Plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage. |
| title_short | Plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage. |
| title_sort | plasma flow distal to tourniquet placement provides a physiological mechanism for tissue salvage |
| url | https://doi.org/10.1371/journal.pone.0244236 |
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