Coagulation, fibrinolysis and cytokine responses to intramedullary nailing of the femur: an experimental study in pigs comparing traditional reaming and reaming with a one-step reamer-irrigator-aspirator system

Injury
Elisabeth Ellingsen HusebyeTorstein Lyberg

Abstract

Operations in trauma patients represent a second insult and the extent of the surgical procedures influences the magnitude of the inflammatory response. Our hypothesis was that a reamer-irrigator-aspirator (RIA) system would cause a lesser inflammatory response than traditional reaming (TR). Coagulation, fibrinolysis and cytokine responses were studied in Norwegian landrace pigs during and after intramedullary nailing (IMN) with two different reaming systems using ELISA and chromogenic peptide substrate assays. The TR (n=8) and the RIA (n=7) reaming systems were compared to a control group (n=7). The animals were followed for 72 h. Arterial, mixed venous and femoral vein blood were withdrawn simultaneously peroperatively and until 2 h after the nail was inserted for demonstration of local, pulmonary and systemic activation of the cascade systems. At 6 h, 24 h, 48 h and 72 h postoperatively arterial blood samples were withdrawn. Significantly procedure-related increased levels were found for thrombin-antithrombin (TAT) and tissue plasminogen activator (t-PA) in the TR group and TAT in the RIA group. The local and the pulmonary activation of coagulation and fibrinolysis were more pronounced in the TR than in the RIA group, the di...Continue Reading

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Citations

Jan 1, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Emmanuel ThienpontJean Cyr Yombi
Dec 15, 2010·Injury·Roman PfeiferHans-Christoph Pape
Dec 15, 2010·Injury·David A VolgasJorge E Alonso
Mar 3, 2017·World Journal of Orthopedics·Enrique Guerado, Enrique Caso
Nov 11, 2017·Acta orthopaedica et traumatologica turcica·Adel EbrahimpourMohammad-Reza Minator Sajjadi
Aug 23, 2020·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Ina LacknerUNKNOWN TREAT Research Group
Apr 21, 2021·Scientific Reports·Birte WeberMiriam Kalbitz

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