In Vitro Respiration of Ischemic Skin from Amputated Human Legs
This study was prompted by the observation that amputations of chronically ischemic, arteriesclcrctic limbs must regularly be performed at a level well above any area of gangrene, if healing of the resultant surgical wound is to be expected.1,2 The skin of such amputated legs grossly appears to be normal, except for any areas of actual gangrene which are generally located at the more distal end of the leg; the skin of these ischemic legs might play some role in maintaining the integrity of the limb, for only when it is disrupted by an injury do the visual signs of tissue breakdown and gangrene develop. Based upon these observations, the twofold purpose of this study was: 1.) to determine if the more distal, non-gangrenous sections of severely ischemic skin, shown in previous experiments by Penneys and Montgomery3,4 to have a very low tissue oxygen tension in vivo, can respire actively when exposed to an adequate 0 supply in vitro; and 2.) to determine whether or not there are any quantitative differences in O2 uptake between these more ischemic, distal, sections and the less ischemic, proximal, sections of skin removed from the same amputated limb, both endogenously and when exposed to certain intermediary metabolic substrates.
KeywordsEpidermal Cell Amputate Limb Skin Section Distal Section Percentage Unit
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- 2.Kelly, P.J. and Janes, J.M. (1970) Criteria for Determining the Proper Level of Amputation in Occlusive Vascular Disease. J. of Bone and Joint Surg. 52: 1685.Google Scholar