Reperfusion injury in free bone grafts after tourniquet-induced ischemia

Journal article


Research Areas

Publication Details

Author list: Sckell A
Publisher: Lippincott, Williams & Wilkins
Publication year: 2003
Issue number: 409
Start page: 306
End page: 316
Number of pages: 11
ISSN: 0009-921X
Languages: English-Great Britain (EN-GB)


For successful revascularization, incorporation, and survival of
fracture fragments or free non-pedicled bone grafts, the first days
after surgery seem to be most critical. Using intravital fluorescence
microscopy, the effects of 3 hours of tourniquet-induced ischemia were
assessed on newly formed angiogenic microvessels 4, 8, and 12 days after
isogeneic transplantation of metatarsal bones into dorsal skin fold
chambers of adult inbred C57BL/6 mice. The microvascular perfusion index
of newly formed microvessels was quantified 30 and 120 minutes after
initiation of reperfusion. Four days after transplantation, a complete
breakdown of the perfusion of all grafts was found accompanied by
hemorrhage as a sign of microvascular damage. In contrast, at 8 and 12
days after transplantation a complete breakdown of graft perfusion
rarely occurred. Therefore, the tourniquet-induced ischemia was most
pronounced in early stages of development of angiogenic microvessels.
These experimental data provide rationale for critical application of
tourniquets in revision surgery shortly after initiation of fracture
treatment or transplantation of free nonpedicled grafts so as not to
compromise angiogenesis-induced tissue revascularization.


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Last updated on 2019-10-08 at 00:15