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Successful Use of Dextran in Phlegmasia Cerulea Dolens

Successful Use of Dextran in Phlegmasia Cerulea Dolens Abstract MASSIVE venous thrombosis is a dramatic event of surgical practice with vivid manifestations of excruciating pain, extensive fluid loss into the affected extremity, and eventual gangrene. Because of this and the relatively poor results of all treatments, phlegmasia cerulea dolens has occasioned frequent reports in the surgical literature (Table 1). The many reports list numerous methods attempting to reduce the complications of this condition. The many forms of therapy are testimony to the fact that no single treatment is satisfactory. Enthusiasm for each mode of care waxes and wanes. Until three decades ago, treatment of phlegmasia cerulea dolens consisted mainly of limb elevation and heparin administration. Sympathetic blockade advocated by Leriche and Kunlin in 1934 and later recommended by DeBakey represented an attempt to halt associated venous and arterial spasm.1 This adjuvant therapy effected some improvement in the morbidity and mortality figures. Boyd and Clarke showed that sympathectomy reduced References 1. Leriche, R., and Kunlin, J.: Traitement immediat des phlebites post-operatoires par infiltration novocainique du sympathique lombaire , Presse Med 43:1481, 1934. 2. Boyd, D.P., and Clarke, F.M.: Phlegmasia Cerulea Dolens , Surgery 51:16, 1962. 3. Brockman, S.K., and Vasko, J.S.: Phlegmasia Cerulea Dolens , Surg Gynec Obstet 121:1347, 1965. 4. Veal, J.R., et al: Acute Massive Venous Occlusion of the Lower Extremities , Surgery 29:355, 1951. 5. Edwards, W.S.: Observations on the Pathogenesis and Management of Massive Venous Occlusion , Surgery 43:153, 1958. 6. Stallworth, J.M., et al: Phlegmasia Cerulea Dolens: A Ten-Year Review , Ann Surg 161:802, 1965.Crossref 7. McDonald, S.T.; Person, W.N.; and Taylor, L.M.: Thrombophlebitis Cerulea Dolens , Arch Surg 80:350, 1960.Crossref 8. Osius, E.A.: Acute Massive Venous Occlusion , Arch Surg 65:19, 1952.Crossref 9. Miles, R.M.: Phlegmasia Cerulea Dolens: Successful Treatment by Vena Cava Ligation , Surgery 30:718, 1951. 10. Fogarty, T.J., et al: Surgical Management of Phlegmasia Cerulea Dolens , Arch Surg 86:256, 1963.Crossref 11. Fogarty, T.J., and Krippaehne, W.M.: Catheter Technique for Venous Thrombectomy , Surg Gynec Obstet 121:362, 1965. 12. Cywes, S., and Louw, J.H.: Phlegmasia Cerulea Dolens: Successful Treatment by Relieving Fasciotomy , Surgery 51:169, 1962. 13. Baker, R.J., et al: Low Molecular Weight Dextran Therapy in Surgical Shock , Arch Surg 89: 373, 1964.Crossref 14. Dextrans for Easing Blood-flow, Editorials , Lancet 1:28 ( (Jan 4) ) 1964. 15. Roe, B.B., et al: Total Body Perfusion in Cardiac Operations , Arch Surg 88:150, 1964.Crossref 16. Dubiel-Tomaszewski, W.; Stern, W.R.; and Hall, D.P.: The Use of Low Molecular Weight Dextran as an Anticoagulant in Left Atrial to Femoral Artery Bypass , J Thorac Cardiov Surg 50:221, 1965. 17. Long, D.M., et al: The Use of Low Molecular Weight Dextran and Serum Albumin as Plasma Expanders in Extracorporeal Circulation , Surgery 50:12, 1961. 18. Drake, C.T.; Macalalad, F.; and Lewis, F.J.: The Effect of Low Molecular Weight Dextran Upon the Blood Flow During Extracorporeal Circulation , J Thorac Cardiov Surg 42:735, 1961. 19. Ratliff, A.H.C.: Low Molecular Weight Dextran in the Treatment of Severe Vascular Insufficiency After Trauma , Lancet 1:1188-1189 ( (June 1) ) 1963.Crossref 20. Bienenstock, J., and Harding, E.L.T.: Low Molecular Weight Dextran in Ischemic Ulceration of the Skin , Lancet 1:524 ( (March 7) ) 1964.Crossref 21. Kwak, H.H.; Mandell, H.B.; and Wilson, D.R.: Beneficial Effect of Low Molecular Weight Dextran on Acute Ischemic Limb , Surg Forum 15:230, 1964. 22. Sawyer, R.B.; Moncrief, J.A.; and Canizaro, P.C.: Dextran Therapy in Thrombophlebitis , JAMA 191:136, 1965.Crossref 23. Cox, E.F.; Flotte, C.T.; and Buxton, R.W.: Dextran in the Treatment of Thrombophlebitis , Surgery 57:225, 1965. 24. Bloom, W.L., et al: Coating of Vascular Surfaces and Cells: A New Concept in Prevention of Intravascular Thrombosis , Proc Soc Exp Biol Med 115:384, 1964.Crossref 25. Just-Viera, J.O., and Yeager, G.H.: Protection From Thrombosis in Large Veins , Surg Gynec Obstet 118:354, 1964. 26. Bernstein, E.F., et al: Effect of Low Molecular Weight Dextran on Red Blood Cell Charge During Clinical Extracorporeal Circulation , Circulation 27:816, 1963.Crossref 27. Wells, R.E.: Rheology of Blood in the Microvasculature , New Eng J Med 270:889, 1964.Crossref 28. Moncrief, J.A., et al: Use of Dextran to Prevent Arterial and Venous Thrombosis , Ann Surg 158:553, 1963.Crossref 29. Bryant, M.F.; Brewer, S.S.; and Bloom, W.C.: Use of Dextran in Preventing Thrombosis of Small Arteries , Clin Res 10:49, 1962. 30. Ernst, C.B., et al: The Role of Low Molecular Weight Dextran in the Management of Venous Thrombosis , Surg Gynec Obstet 119:1243, 1964. 31. Litwin, M.S.: Blood Viscosity in Shock , Amer J Surg 110:313, 1965.Crossref 32. Schwartz, S.I., et al: Effect of Low Molecular Weight Dextran on Flow , Surgery 55:106, 1964. 33. Bergan, J.J.: Unpublished data. 34. Munster, A.M.: Low Molecular Weight Dextran in the Treatment of Phlegmasia Cerulea Dolens , Med J Aust 1:851, 1965. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Successful Use of Dextran in Phlegmasia Cerulea Dolens

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01330010035005
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Abstract

Abstract MASSIVE venous thrombosis is a dramatic event of surgical practice with vivid manifestations of excruciating pain, extensive fluid loss into the affected extremity, and eventual gangrene. Because of this and the relatively poor results of all treatments, phlegmasia cerulea dolens has occasioned frequent reports in the surgical literature (Table 1). The many reports list numerous methods attempting to reduce the complications of this condition. The many forms of therapy are testimony to the fact that no single treatment is satisfactory. Enthusiasm for each mode of care waxes and wanes. Until three decades ago, treatment of phlegmasia cerulea dolens consisted mainly of limb elevation and heparin administration. Sympathetic blockade advocated by Leriche and Kunlin in 1934 and later recommended by DeBakey represented an attempt to halt associated venous and arterial spasm.1 This adjuvant therapy effected some improvement in the morbidity and mortality figures. Boyd and Clarke showed that sympathectomy reduced References 1. Leriche, R., and Kunlin, J.: Traitement immediat des phlebites post-operatoires par infiltration novocainique du sympathique lombaire , Presse Med 43:1481, 1934. 2. Boyd, D.P., and Clarke, F.M.: Phlegmasia Cerulea Dolens , Surgery 51:16, 1962. 3. Brockman, S.K., and Vasko, J.S.: Phlegmasia Cerulea Dolens , Surg Gynec Obstet 121:1347, 1965. 4. Veal, J.R., et al: Acute Massive Venous Occlusion of the Lower Extremities , Surgery 29:355, 1951. 5. Edwards, W.S.: Observations on the Pathogenesis and Management of Massive Venous Occlusion , Surgery 43:153, 1958. 6. Stallworth, J.M., et al: Phlegmasia Cerulea Dolens: A Ten-Year Review , Ann Surg 161:802, 1965.Crossref 7. McDonald, S.T.; Person, W.N.; and Taylor, L.M.: Thrombophlebitis Cerulea Dolens , Arch Surg 80:350, 1960.Crossref 8. Osius, E.A.: Acute Massive Venous Occlusion , Arch Surg 65:19, 1952.Crossref 9. Miles, R.M.: Phlegmasia Cerulea Dolens: Successful Treatment by Vena Cava Ligation , Surgery 30:718, 1951. 10. Fogarty, T.J., et al: Surgical Management of Phlegmasia Cerulea Dolens , Arch Surg 86:256, 1963.Crossref 11. Fogarty, T.J., and Krippaehne, W.M.: Catheter Technique for Venous Thrombectomy , Surg Gynec Obstet 121:362, 1965. 12. Cywes, S., and Louw, J.H.: Phlegmasia Cerulea Dolens: Successful Treatment by Relieving Fasciotomy , Surgery 51:169, 1962. 13. Baker, R.J., et al: Low Molecular Weight Dextran Therapy in Surgical Shock , Arch Surg 89: 373, 1964.Crossref 14. Dextrans for Easing Blood-flow, Editorials , Lancet 1:28 ( (Jan 4) ) 1964. 15. Roe, B.B., et al: Total Body Perfusion in Cardiac Operations , Arch Surg 88:150, 1964.Crossref 16. Dubiel-Tomaszewski, W.; Stern, W.R.; and Hall, D.P.: The Use of Low Molecular Weight Dextran as an Anticoagulant in Left Atrial to Femoral Artery Bypass , J Thorac Cardiov Surg 50:221, 1965. 17. Long, D.M., et al: The Use of Low Molecular Weight Dextran and Serum Albumin as Plasma Expanders in Extracorporeal Circulation , Surgery 50:12, 1961. 18. Drake, C.T.; Macalalad, F.; and Lewis, F.J.: The Effect of Low Molecular Weight Dextran Upon the Blood Flow During Extracorporeal Circulation , J Thorac Cardiov Surg 42:735, 1961. 19. Ratliff, A.H.C.: Low Molecular Weight Dextran in the Treatment of Severe Vascular Insufficiency After Trauma , Lancet 1:1188-1189 ( (June 1) ) 1963.Crossref 20. Bienenstock, J., and Harding, E.L.T.: Low Molecular Weight Dextran in Ischemic Ulceration of the Skin , Lancet 1:524 ( (March 7) ) 1964.Crossref 21. Kwak, H.H.; Mandell, H.B.; and Wilson, D.R.: Beneficial Effect of Low Molecular Weight Dextran on Acute Ischemic Limb , Surg Forum 15:230, 1964. 22. Sawyer, R.B.; Moncrief, J.A.; and Canizaro, P.C.: Dextran Therapy in Thrombophlebitis , JAMA 191:136, 1965.Crossref 23. Cox, E.F.; Flotte, C.T.; and Buxton, R.W.: Dextran in the Treatment of Thrombophlebitis , Surgery 57:225, 1965. 24. Bloom, W.L., et al: Coating of Vascular Surfaces and Cells: A New Concept in Prevention of Intravascular Thrombosis , Proc Soc Exp Biol Med 115:384, 1964.Crossref 25. Just-Viera, J.O., and Yeager, G.H.: Protection From Thrombosis in Large Veins , Surg Gynec Obstet 118:354, 1964. 26. Bernstein, E.F., et al: Effect of Low Molecular Weight Dextran on Red Blood Cell Charge During Clinical Extracorporeal Circulation , Circulation 27:816, 1963.Crossref 27. Wells, R.E.: Rheology of Blood in the Microvasculature , New Eng J Med 270:889, 1964.Crossref 28. Moncrief, J.A., et al: Use of Dextran to Prevent Arterial and Venous Thrombosis , Ann Surg 158:553, 1963.Crossref 29. Bryant, M.F.; Brewer, S.S.; and Bloom, W.C.: Use of Dextran in Preventing Thrombosis of Small Arteries , Clin Res 10:49, 1962. 30. Ernst, C.B., et al: The Role of Low Molecular Weight Dextran in the Management of Venous Thrombosis , Surg Gynec Obstet 119:1243, 1964. 31. Litwin, M.S.: Blood Viscosity in Shock , Amer J Surg 110:313, 1965.Crossref 32. Schwartz, S.I., et al: Effect of Low Molecular Weight Dextran on Flow , Surgery 55:106, 1964. 33. Bergan, J.J.: Unpublished data. 34. Munster, A.M.: Low Molecular Weight Dextran in the Treatment of Phlegmasia Cerulea Dolens , Med J Aust 1:851, 1965.

Journal

Archives of SurgeryAmerican Medical Association

Published: Jul 1, 1966

References