Cross-limb vascular shunting for major limb replantation.

摘要

I wish to address the following comments to the authors of the article "Cross Limb Vascular Shunting for Major Limb Replantation." First of all, I congratulate the authors on the success of their case and their improved methods of cross-limb vascular shunting as published in the 2009 article. The application of the shunting technique in replantation surgery produces a very good result.Although we know that fingers can tolerate warm ischemia time up to 42 hours and cold ischemia time up to 94 hours, muscles can only withstand 4 hours of ischemia. Therefore, it is better to complete the revascularization of a major limb amputation within 4 hours. However, in remote areas, patients oftentimes cannot be transported to a medical center within the time limit.