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Ann Thorac Surg 2000;70:229-233
© 2000 The Society of Thoracic Surgeons
a Heineman Medical Research Laboratory, Carolinas Medical Center, Charlotte, North Carolina, USA
b Department of Thoracic and Cardiovascular Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA
Address reprint requests to Dr Robicsek, Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC 28203
Background. The possibility of confinement of simulated retrovirus to the inoculation site after needlestick injuries to enhance chances of local intervention and function of lymphaticovenous communications was investigated.
Methods. Using the canine model, technetium-99 m sulfur colloid particles were injected subcutaneously and into the vein and lymphatics. Blood and lymph were collected at a higher level from the femoral vein and the major lymphatic. Flow rates, particle arrival times, concentrations, and other variables were evaluated for 45 minutes by
counting. A tourniquet was used to slow dissemination after subcutaneous injection.
Results. After subcutaneous inoculation, particles arrived in the blood at 2.81 ± 0.54 minutes and in the lymph at 6.0 ± 1.47 minutes. Application of a tourniquet delayed appearance in the blood to 7.11 ± 1.5 minutes and in the lymph to 40.0 ± 5.1 minutes. Concentration of particles in lymph was 1,000 times higher than in the blood. Flux values were comparable in both pathways, but accumulation patterns were different. After intravenous injection, particles arrived in lymph at 25.4 ± 6.44 minutes. After intralymphatic injection particles arrived in the blood within 4 seconds.
Conclusions. There are functional lymphaticovenous communications at the peripheral level. The period between virus inoculation and blood and lymph invasion may be extended by application of a tourniquet; therefore, time could be gained for local intervention.
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A. A. Fokin, F. Robicsek, T. N. Masters, and C. R. Swan Protection of a Surgeon From Dangerous Needlesticks Ann. Thorac. Surg., November 1, 2004; 78(5): 1882 - 1882. [Full Text] [PDF] |
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