Experimental studies on the lymphatic regeneration and formation of lymphatic collateral circulation after replantation of incompletely severed limbs

Abstract

After replantation of incompletely severed limbs had been performed in the thighs of the hind legs of 5 dogs, the time and form of lymphatic regeneration and its relation to the subsidence of edema were studied by lymphangiography with direct technic (group 1). Radiogram taken in the 3rd week postoperatively showed the beginning of lymphatic regeneration. In the 5th week the lymphatic trunks were completely connected and returned to normal. However, no formation of collateral lymphatic circulation could be seen. In the other 5 dogs (group 2) the femoral arteries and veins were ligated and severed instead of being re-anastomosed, and it was found that a collateral lymphatic took part in lymphatic drainage in the 1st week. With regeneration and connection of the severed lymphatics in the 3rd week, the collateral lymphatics gradually disappeared except in one case when it remained visible until the 7th week. Proof is present that the lymphatics play an important role in assisting the vein to overcome edema and to restore the normal condition of the limbs. This study offers a theoretical basis for clinical practice that there is no need to anastomose the severed lymphatics during replantation of severed limbs and other transplantation operations.

Keywords

replantation of severed limbs / regeneration of lymphatic vessels / lymphatic collateral circulation

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