ASSESSMENT OF RESIDUAL VASCULARIZATION OF THE LIMB AS A PROGNOSTIC FACTOR TO AVOID SEA TURTLE FLIPPER AMPUTATION

D. Franchini, C. Valastro, S. Ciccarelli, M. Ricciardi, D. Lenoci, M. Corrente, A. D. Bello
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引用次数: 7

Abstract

Abstract: Entanglement occurs when a marine turtle becomes trapped within anthropogenic materials such as debris or fishery gear, inducing strangulation of anatomical parts such as flippers or the neck, causing deep lacerations, maiming, amputation, or choking. Often, severely entangled flippers in captured or stranded turtles are removed surgically. Turtles with flipper impairment have difficulty in swimming, diving, and feeding. Our aim was to use color Doppler ultrasound and multi-detector computer tomography to evaluate residual vascularization or neovascularization in severely entangled flippers of loggerhead sea turtles (Caretta caretta) to assess viability of flippers, even in the absence of limb sensation. We studied 12 turtles with either unilateral (n=8) or bilateral (n=4) involvement. A total of 14 flippers were severely entangled and two flippers were spontaneously amputated. Only two of the 14 entangled flippers had to be removed surgically. For 12 entangled flippers, after surgical curettage, the treatment protocol was based on the use of a plant-derived commercial dressing. The animals were monitored and treated for 1–3 mo, until the soft tissue defects were completely healed by secondary intention. Interestingly, in the treated animals the healing flippers steadily recovered motility and sensation, restoring the complete functionality of the flipper. Vascularization of the limb was found to be critical to prevent amputation of entangled flippers, preserving the flipper and its functionality with conservative therapy and avoiding amputation as much as possible. Our study showed that in cases of entanglement, amputation does not need to be performed immediately but can wait for nonviability to declare itself following conservative therapy and should be reserved as a last-resort treatment.
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评估残肢血管化作为避免海龟肢肢截肢的预后因素
摘要:当海龟被人为材料(如碎片或渔具)困住时,会导致鳍部或颈部等解剖部位被勒死,造成深度撕裂、致残、截肢或窒息。通常,在捕获或搁浅的海龟中,严重缠绕的鳍肢会通过手术切除。脚蹼受损的海龟在游泳、潜水和进食方面有困难。我们的目的是使用彩色多普勒超声和多探测器计算机断层扫描来评估严重缠结的红海龟(Caretta Caretta)脚蹼的残余血管形成或新生血管形成,以评估即使在没有肢体感觉的情况下脚蹼的生存能力。我们研究了12只单侧(n=8)或双侧(n=4)受累的海龟。共有14只脚蹼被严重缠绕,2只脚蹼被自发截肢。14只缠在一起的鳍中只有两只需要通过手术切除。对于12只纠缠的鳍,在手术刮除后,治疗方案是基于使用植物衍生的商业敷料。观察治疗1 ~ 3个月,直至软组织缺损二次愈合。有趣的是,在接受治疗的动物中,愈合的鳍稳定地恢复了运动和感觉,恢复了鳍的完整功能。肢体血管化是防止缠结肢截肢的关键,通过保守治疗保留肢端及其功能,并尽可能避免截肢。我们的研究表明,在缠结的情况下,截肢不需要立即进行,但可以等待在保守治疗后丧失生存能力,并应保留作为最后的治疗手段。
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