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Related Experiment Videos

Delayed toe transplantation: experimental study and clinical application.

Y Gu1, S Li, D Chen

  • 1Department of Hand Surgery at Huashan Hospital, Shanghai Medical University, People's Republic of China. ilao@public4.sta.net.cn

Plastic and Reconstructive Surgery
|May 16, 2000
PubMed
Summary
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Delayed toe transplantation, performed 17-21 hours after dissection due to circulatory crisis, achieved 100% survival. This method, involving delayed pedicle division, effectively manages vascular variations and crises in toe transfers.

Area of Science:

  • Microsurgery
  • Vascular Surgery
  • Transplantation Biology

Background:

  • Toe transplantation is a complex procedure often complicated by circulatory crisis.
  • Vascular variations can impede immediate toe transfer.
  • Successful outcomes in challenging cases require innovative surgical timing.

Purpose of the Study:

  • To evaluate the efficacy of delayed toe transplantation in cases of circulatory crisis.
  • To investigate the underlying physiological mechanisms of delayed toe transfer.
  • To determine the optimal timing for pedicle division and toe transfer.

Main Methods:

  • Ten clinical cases of toe transplantation with delayed transfer (17-21 hours post-dissection) due to circulatory crisis were analyzed.
  • Animal experiments in 36 rabbits involved hind limb severance, preserving the vascular pedicle.

Related Experiment Videos

  • Endothelin and nitric oxide levels in local tissues and arterial walls were measured at various postoperative intervals (4, 8, 16, 24, 48 hours).

    • Main Results:

    • All 10 clinical cases of delayed toe transplantation resulted in 100% graft survival.
    • In rabbit models, a significant increase in endothelin and decrease in nitric oxide were observed 4-8 hours post-operation.
    • By 16-24 hours post-operation, endothelin levels normalized, and nitric oxide levels significantly increased.

    Conclusions:

    • Delayed pedicle division and toe transfer is a highly effective strategy for toe transplantation, particularly in the presence of vascular variations and circulatory crisis.
    • The mechanism of success is linked to dynamic changes in local tissue and arterial wall endothelin and nitric oxide levels.
    • This approach offers a viable solution for improving outcomes in challenging toe transplant scenarios.