[Studies on microcirculation injury of skeletal muscle due to tourniquet-induced ischemia]

Blood flow does not return to all areas after long period of ischemia produced by tourniquet application. The cause of this "no-reflow phenomenon" is still a matter of controversy. The purpose of this study was to investigate the relationship between thrombus formation and the no-reflow phenomenon by comparing the change of platelet function and the findings of vessel lumen observed by scanning electron microscopy. Through the results of a microangiogram, the author confirmed that the no-reflow phenomenon occurred on the first day and disappeared on the fifth day after the tourniquet was released. Mean volume, maximum aggregation and malondialdehyde of platelets decreased at two hours to one day after tourniquet release due to the consumption of larger platelets. There were irregular endothelia and a mural thrombus in the veins of the ischemic leg on the first day following release of the tourniquet. These findings suggest that thrombus formation plays an important role in the development of the no-reflow phenomenon.