Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2023; 11(20): 4926-4931
Published online Jul 16, 2023. doi: 10.12998/wjcc.v11.i20.4926
Pretreatment with a modified St. Thomas' solution in patients with severe upper limb injuries: Four case reports
Zhong-Yang Sun, Li-Yi Li, Jian-Xin Xing, Liang-Cheng Tong, Ying Li
Zhong-Yang Sun, Li-Yi Li, Jian-Xin Xing, Liang-Cheng Tong, Ying Li, Department of Orthopedics, Air Force Hospital of Eastern Theater, Nanjing 210002, Jiangsu Province, China
Author contributions: Sun ZY contributed to the conceptualization; Li Y and Li LY contributed to the methodology; Xing JX contributed to the software; Xing JX and Tong LC contributed to the validation; Tong LC and Li Y contributed to the formal analysis; Li Y contributed to the investigation and resources; Sun ZY contributed to the data curation and writing-review & editing; Sun ZY and Li LY contributed to the writing-original draft preparation; Li LY contributed to the visualization; Sun ZY and Li Y contributed to the supervision and project administration; all authors have read and approved the final submitted manuscript.
Supported by the National Natural Science Foundation of China, No. 81600694; and the Science and Technology Project of Nanjing, No. 201503008.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying Li, Doctor, MD, Associate Professor, Department of Orthopedics, Air Force Hospital of Eastern Theater, No. 1 Malu Street, Nanjing 210002, Jiangsu Province, China. ying4547@163.com
Received: March 16, 2023
Peer-review started: March 16, 2023
First decision: April 28, 2023
Revised: May 19, 2023
Accepted: June 16, 2023
Article in press: June 16, 2023
Published online: July 16, 2023
Processing time: 118 Days and 6.5 Hours
Abstract
BACKGROUND

This study aims to describe the application of a modified St. Thomas' solution in patients with severe limb injuries.

CASE SUMMARY

Four patients who sustained a high-energy trauma and underwent complete upper limb amputation were pretreated with a modified St. Thomas' solution before upper limb replantation. After the perfusion solution stopped flowing from the blood vessel, the amputated upper limb amputation was replanted. The patients were instructed to perform functional rehabilitation training after the operation. All 4 patients were followed up for 5 years. All the severed upper limbs survived. Routine re-examination after the operation showed that the function of the affected limb was restored. All the patients were satisfied with the sensory and functional recovery of the affected limb.

CONCLUSION

The modified St. Thomas' solution can effectively improve the success rate of limb salvage surgery and the recovery of limb function in patients with a severe limb injury.

Keywords: Severe upper limb injury; Preperfusion; Modified St. Thomas' solution; Case report

Core Tip: The modified St. Thomas' solution can effectively improve the success rate of limb salvage surgery and the recovery of limb function in patients with a severe limb injury.