A perfusion system for preparing the victim and the ischemic limb for reimplantation

The authors have developed and tested an original perfusion system for rapid and effective simultaneous preparation of the victim and the traumatically amputated limb, after a long period of ischemia, for reimplantation. The extracorporeal circuit of the circulatory system includes the main drainage channels, reservoirs for holding the perfusion fluid, peristaltic (roller) pumps, a column containing the hemosorbent, a low-output membrane oxygenator with heat exchanger (LMO-HE) (International Standard), the isolated donor's spleen, an ultraviolet source (UVS) for irradiating the blood, the rotor of the RK-0.5 blood fractionator, and transducers for measuring perfusion pressure 16 and temperature. The tests showed that the suggested perfusion system can provide a highly effective combined method of preparation of the victim and of the amputated limb for reimplantation. This is revealed by the rapid development of general and local detoxication, complete inactivation and elimination of bacteria, rapid recovery of muscular electrical excitability, and the very slow development of edema of the reimplanted tissues, a reduction in the number of early postoperative complications, and improvement of the results of surgical treatment.