Disposable intravenous infusion sets as a temporary intravascular shunt for major limb replantation: a retrospective study

Objective: The key to increasing the success rate of limb preservation lies in timely restoration of the blood supply to the severed limb, This study examines the clinical effect of a disposable intravenous infusion device as a temporary vascular shunt device which can quickly restore blood circulation in the replantation of severed limbs.

Methods: A retrospective review of all amputated major limbs in our department from May 2005 to May 2022. Patients treated with intravenous infusion tubes as temporary vascular shunt devices were included in group A(shunt group ) and those who could not use temporary intravascular shunt devices were included in group B (no shunt group). The durations of temporary vascular shunt placement and continuous placement during the operation were recorded, and the rates of limb survival and complications ( thrombosis and osteofascial compartment syndrome, infection) were evaluated after the operation. A comparison of complications, the postoperative function between the two groups was also performed.

Results: A total of 67 patients were included: group A (shunt group, n = 35) and group B (no shunt group, n = 32), The average duration of temporary vascular shunt placement in all patients was 10 ± 1.5 min. The rate of amputation and the incidence of thrombus compartment syndrome and infection were statistically different between the two groups (P < 0.05), There was no significant difference in thrombosis rate between the two groups. All patients were followed up for a mean of 32.5 (8-60) months. The DASH scores of group A and group B at the last follow-up were 65 ± 8.5 points and 85 ± 6.5 points respectively and The Maryland foot scores of group A and group B at the last follow-up were 58 ± 4.5 points and 35 ± 5.5 points respectively, There were statistical differences in function between the two groups(P < 0.05).

Conclusion: A disposable intravenous infusion device as a temporary vascular shunt device can be effectively and practically used for reducing the warm ischemia time and significantly improving the successful limb replantation rate and is therefore worthy of clinical application.