Lactate Levels in a Replanted Limb as an Early Biomarker for Assessing Post-Surgical Evolution: A Case Report

<b>Background and Clinical Significance:</b> In the clinical management of major pediatric traumatic injuries and other hypoxic conditions, lactate is widely recognized as a key indicator of tissue hypoxia and potential necrosis. However, its prognostic value remains uncertain. Several f...

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Main Authors: Alina Belu, Viorel Țarcă, Nina Filip, Elena Țarcă, Laura Mihaela Trandafir, Rodica Elena Heredea, Silviana Chifan, Diana Elena Parteni, Jana Bernic, Elena Cojocaru
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/6/688
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author Alina Belu
Viorel Țarcă
Nina Filip
Elena Țarcă
Laura Mihaela Trandafir
Rodica Elena Heredea
Silviana Chifan
Diana Elena Parteni
Jana Bernic
Elena Cojocaru
author_facet Alina Belu
Viorel Țarcă
Nina Filip
Elena Țarcă
Laura Mihaela Trandafir
Rodica Elena Heredea
Silviana Chifan
Diana Elena Parteni
Jana Bernic
Elena Cojocaru
author_sort Alina Belu
collection DOAJ
description <b>Background and Clinical Significance:</b> In the clinical management of major pediatric traumatic injuries and other hypoxic conditions, lactate is widely recognized as a key indicator of tissue hypoxia and potential necrosis. However, its prognostic value remains uncertain. Several factors influence post-surgical outcomes, including the time between amputation and replantation, transport conditions, asepsis, the extent of tissue necrosis, hemorrhagic shock, coagulation disorders, and the heightened risk of contamination. <b>Case presentation:</b> We present this case to emphasize the utility of systemic lactate versus lactate levels in the replanted limb for monitoring post-transplantation outcomes in a pediatric patient with traumatic limb amputation. Significant fluctuations in lactate levels within the replanted limb were observed at the onset of unfavorable evolution, specifically on the seventh postoperative day, coinciding with the identification of <i>Aspergillus</i> spp. infection. This necessitated the use of synthetic saphenous vein grafts and Amphotericin B administration. Despite these interventions, disease progression ultimately led to limb amputation. <b>Conclusions:</b> Lactate levels in the replanted limb may serve as an early biomarker for assessing post-surgical evolution. However, further case reports are required to confirm its predictive value.
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spelling doaj-art-ee100614f3154a8f92cf5d46b2e500472025-08-20T03:43:26ZengMDPI AGDiagnostics2075-44182025-03-0115668810.3390/diagnostics15060688Lactate Levels in a Replanted Limb as an Early Biomarker for Assessing Post-Surgical Evolution: A Case ReportAlina Belu0Viorel Țarcă1Nina Filip2Elena Țarcă3Laura Mihaela Trandafir4Rodica Elena Heredea5Silviana Chifan6Diana Elena Parteni7Jana Bernic8Elena Cojocaru9Department of Morphofunctional Sciences I—Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Preclinical Disciplines, Faculty of Medicine, Apollonia University, Strada Păcurari nr. 11, 700511 Iași, RomaniaDepartment of Morphofunctional Sciences II—Biochemistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iaşi, RomaniaDepartment of Surgery II—Pediatric Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Mother and Child—Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment I Nursing, Discipline of Clinical Practical Skills, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, RomaniaFaculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Morphofunctional Sciences I—Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDiscipline of Pediatric Surgery, “Nicolae Testemițanu” State University of Medicine and Pharmacy, MD-2001 Chisinau, MoldovaDepartment of Morphofunctional Sciences I—Pathology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania<b>Background and Clinical Significance:</b> In the clinical management of major pediatric traumatic injuries and other hypoxic conditions, lactate is widely recognized as a key indicator of tissue hypoxia and potential necrosis. However, its prognostic value remains uncertain. Several factors influence post-surgical outcomes, including the time between amputation and replantation, transport conditions, asepsis, the extent of tissue necrosis, hemorrhagic shock, coagulation disorders, and the heightened risk of contamination. <b>Case presentation:</b> We present this case to emphasize the utility of systemic lactate versus lactate levels in the replanted limb for monitoring post-transplantation outcomes in a pediatric patient with traumatic limb amputation. Significant fluctuations in lactate levels within the replanted limb were observed at the onset of unfavorable evolution, specifically on the seventh postoperative day, coinciding with the identification of <i>Aspergillus</i> spp. infection. This necessitated the use of synthetic saphenous vein grafts and Amphotericin B administration. Despite these interventions, disease progression ultimately led to limb amputation. <b>Conclusions:</b> Lactate levels in the replanted limb may serve as an early biomarker for assessing post-surgical evolution. However, further case reports are required to confirm its predictive value.https://www.mdpi.com/2075-4418/15/6/688lactatepediatric traumalimb replantationpostoperative prognosis
spellingShingle Alina Belu
Viorel Țarcă
Nina Filip
Elena Țarcă
Laura Mihaela Trandafir
Rodica Elena Heredea
Silviana Chifan
Diana Elena Parteni
Jana Bernic
Elena Cojocaru
Lactate Levels in a Replanted Limb as an Early Biomarker for Assessing Post-Surgical Evolution: A Case Report
Diagnostics
lactate
pediatric trauma
limb replantation
postoperative prognosis
title Lactate Levels in a Replanted Limb as an Early Biomarker for Assessing Post-Surgical Evolution: A Case Report
title_full Lactate Levels in a Replanted Limb as an Early Biomarker for Assessing Post-Surgical Evolution: A Case Report
title_fullStr Lactate Levels in a Replanted Limb as an Early Biomarker for Assessing Post-Surgical Evolution: A Case Report
title_full_unstemmed Lactate Levels in a Replanted Limb as an Early Biomarker for Assessing Post-Surgical Evolution: A Case Report
title_short Lactate Levels in a Replanted Limb as an Early Biomarker for Assessing Post-Surgical Evolution: A Case Report
title_sort lactate levels in a replanted limb as an early biomarker for assessing post surgical evolution a case report
topic lactate
pediatric trauma
limb replantation
postoperative prognosis
url https://www.mdpi.com/2075-4418/15/6/688
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