Early detection of muscular changes in ischemia should be the utmost important and urgent problem in management and recovery of the muscles before irreversible picture developes.
In the relevant literatures, many authors have studied upon histological changes of muscles in ischemia employing various staining methods, such as hematoxylin and eosin(H&E), van. Gieson etc., and reported that the earliest possible time for detection of morphological changes-in muscles were 3 to 4 hours after ischemia took place. Other methods, such as measurement of´ pressure in the muscular tissue with wick catheter, nerve conduction time, electromyography, tissue fluid analysis, enzyme study of serum, lactic acid study, 99-Tc stannous pyrophosphate, electronmicroscopic study did not provide valuable early detection of muscular changes in ischemia.
The author has undertaken an experimental study upon morphological changes of the muscles. after ischemia were produced artificially with ligation of vessels and using tourniquet, and tried_ to detect early changes in the ischemic muscle by histochemical staining method developed by Lie et al., hematoxylin basic fuchsinpicric acid(HBFP) staining method 20).
Twenty rabbits, weighing 2, 000-2, 500gm were divided into two groups. In group 1, tourniquet was applied on the proximal thigh, and in group 2, the unilateral common iliac artery and vein were ligated. In each group, muscle biopsies were carried out of the belly of the anterior tibial muscles in 10 minutes, 30 minutes, 1 hour, 2 hours, 3 hours, 6 hours, 24 hours, and 48 hours, respectively, while the applied tourniquet or ligation was released 6hours after application. The biopsied samples were fixed in formalin and stained with H&E and HBFP stain for microscopic evaluation of muscle changes.
The results are as follows:
1. In group 1, the earliest evidence-of muscular degeneration were detected by HBFP staining method as early as 30 minutes after application of tourniquet, whereas it was required at-least 3 hours to detect such change by H&E staining method.
2. In group 2, the earliest evidence of muscular degeneration were detected by HBFP staining method as early as 10 minutes after ligation of the vessels, whereas it was required atleast 2 hour to detect such change by H&E staining method.
3. In group 2, the minimal elapse of the time to detect muscular necrosis after ligation of the v--3sel was 2 hours by HBFP staining method whereas it took 24 hours by H&E staining method.
4. The above findings suggest that the HBFP staining is the most practical method to detect not only early degenerative change of muscle but the evaluation of the extent of the changes due to ischemia.
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