Regional Limb Perfusion

Regional Limb Perfusion



Basic Information image



Synonym(s)




Intravenous regional perfusion


Intraosseous regional perfusion


Regional perfusion



Overview and Goal(s)


Regional limb perfusion is a technique adapted from human medicine by which a selected part of an extremity’s vascular supply can be isolated by the use of a tourniquet, and in this manner treated independently to the rest of the body. It is used to provide high levels of a pharmaceutical, commonly antibiotics, in the selected and isolated region of the lower extremity.



Indications




• Septic arthritis


• Osteomyelitis


• Recalcitrant infections



Equipment, Anesthesia




• The intravenous variant of this technique requires:


image Tourniquet (12-inch rubber tubing or pneumatic tourniquet applied to a pressure above systolic)

image 20- or 22-gauge catheter or butterfly needle

image Extension set

• The intraosseous variant of this technique requires:


image Tourniquet (12-inch rubber tubing or pneumatic)

image Cannulated screw (commercially available or custom-made of 4.5 mm diameter) (Figure 1)

image 3.2-mm drill bit and 4.5-mm tap

image 3.2-mm drill guide/tissue protector

image Air or electric drill

image Extension set

• Both procedures (intravenous or intraosseous) can be performed in the standing horse under heavy sedation. The intraosseous variant requires local anesthetic in the region and a small incision to place the drill bit against the bone, commonly the third metacarpal or metatarsal, where a unicortical hole is drilled into the medullary cavity (Figures 2 and 3).

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Regional Limb Perfusion

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