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Towards Portable Leg Perfusion: Initial Prototype Testing of a Selective Leg Perfusion System.

George Harea1,2,3, Ian J Stewart4, Lawrence Renna1

  • 1Autonomous Reanimation and Evacuation Research Institute (AREVA), The Geneva Foundation, San Antonio, TX 78235, United States.

Military Medicine
|September 23, 2025
PubMed
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This summary is machine-generated.

Developing an extracorporeal limb perfusion system can preserve limbs in combat casualties. This novel approach shows promise for limb salvage when evacuation is delayed, reducing tissue damage and improving outcomes.

Area of Science:

  • Biomedical Engineering
  • Trauma Surgery
  • Organ Preservation

Background:

  • Limb loss is a significant cause of morbidity in combat casualties.
  • Tourniquets save lives but can cause prolonged ischemia due to delayed evacuation.
  • A dedicated extracorporeal limb perfusion system is being developed for organ preservation.

Purpose of the Study:

  • To present preliminary data on the feasibility of a dedicated extracorporeal limb perfusion system.
  • To evaluate the efficacy of limb preservation in a simulated combat casualty scenario.

Main Methods:

  • Amputated swine hindlimbs were perfused for 6 hours using a system with and without a membrane oxygenator.
  • Key parameters including temperature, blood flow, and arterial blood gases were monitored hourly.

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  • Histological analysis was performed and compared to limbs in cold storage.

    • Main Results:

    • The oxygenated perfusion group (OXY+) demonstrated significantly higher blood pH, base excess, and oxygen saturation compared to the non-oxygenated group (OXY-).
    • The OXY+ group also had lower partial pressure of carbon dioxide (pCO2).
    • Histological analysis revealed reduced sarcoplasm and sarcolemma damage in the OXY+ group after 6 hours.

    Conclusions:

    • The developed perfusion system successfully maintained limb circulation without adverse clotting events.
    • This purpose-built perfusion system shows promise for limb preservation in large-scale combat operations with delayed evacuation.
    • Further development is warranted to optimize limb salvage strategies in military medicine.