Limb perfusion is a medical technique that is used to deliver drugs locally directly to a site of interest. It is commonly used in human medicine for administration of anticancer drugs directly to an arm or leg . It is also used in veterinary medicine to deliver drugs to a site of infection or injury, as well as for the treatment of cancer in dogs. In both cases, a tourniquet is used to reduce blood flow out of the area that is being treated.
15-432: RLP may refer to: Medicine and chemistry [ edit ] 2,3-diketo-5-methylthiopentyl-1-phosphate enolase , an enzyme Regional limb perfusion , a method of medication delivery in animals. Round Ligament Pain , a pain of the round ligament of uterus Computing [ edit ] Radio Link Protocol , an automatic repeat request fragmentation protocol used over
30-471: A federal state of the Federal Republic of Germany Riverside Long Playing, serial number for Riverside Records LP albums Rohingya Liberation Party , Rakhine State, Myanmar Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title RLP . If an internal link led you here, you may wish to change the link to point directly to
45-414: A shorter duration. However, expense is usually less of a limiting factor because a smaller amount may be used relative to systemic administration. Limb perfusion of carbapenem antibiotics such as imipenem and meropenem have been studied in horses. However, a retrospective study comparing horses that received meropenem via RLP for orthopedics sepsis to a group of horses that received gentamicin via RLP for
60-598: A synovial structure (joint, tendon sheath, bursa), or osteomyelitis . RLP has been shown to produce antibiotic concentrations 25-50 times the minimum inhibitory concentration in septic joints. Antibiotic selection is important. Antibiotics must be approved for intravenous use, and are ideally chosen based on culture and susceptibility results. Concentration-dependent antibiotics , such as gentamicin and amikacin, are best suited for RLP because they have higher efficacy at higher concentrations, while time-dependent antibiotics such as penicillin and ceftiofur may be used, but have
75-467: A wireless (typically cellular) air interface RLP (complexity) , the complexity class of problems solvable by a probabilistic machine in logarithmic space and polynomial time with one-sided error Other uses [ edit ] Rashtriya Loktantrik Party , an independent political party in India. Reel Life Productions , an independent record label founded by rapper Esham Rhineland-Palatinate ,
90-404: Is a route of administration of medication, nutrition or other substance into the circulatory system so that the entire body is affected. Administration can take place via enteral administration (absorption of the drug through the gastrointestinal tract) or parenteral administration (generally injection, infusion, or implantation). Contrast with topical administration where the effect
105-585: Is also used to deliver chemotherapeutic agents. Side effects of RLP are relatively rare when performed correctly. Partial thrombosis of a vein can occur, especially with repeated use of a vein, but complete thrombosis is rare. There may also be localized tissue irritation. Topical application of an anti-inflammatory, such as DMSO or Diclofenac sodium may be used. [REDACTED] This article incorporates public domain material from Dictionary of Cancer Terms . U.S. National Cancer Institute . Systemic administration Systemic administration
120-499: Is placed above the site of interest, and a needle inserted into a superficial vein of the limb below the tourniquet. The medication is delivered and the tourniquet is removed after 20–30 minutes. Because of the size of the limbs, RLP is not possible above the elbow or stifle of a horse because of inadequate compression of the underlying blood vessels. Limb perfusion is commonly used for antibiotic administration in cases of localized infection, such as lacerations, cellulitis , infection of
135-412: The limb is temporarily stopped with a tourniquet , and anticancer drugs are put directly into the blood of the limb. This allows the person to receive a high dose of drugs in the area where the cancer occurred. The temperature is also increased to 42C causing an increased uptake of the drug by the tumor. The combination of high drug dose and high temperature is toxic systemically, thus the isolation of
150-805: The early 1990s an alternative technique was developed at the Royal Prince Alfred Hospital in Sydney, Australia: isolated limb infusion. This technique is less complex and uses a minimal invasive percutaneous approach to circulatorily isolate a limb. Limb perfusion is also used in veterinary medicine, where is it usually referred to as regional limb perfusion (RLP). It is most commonly used in large animals, such as horses, cows, small ruminants, and camelids. These species often require large, cost-prohibitive doses of medications to treat systemically . Regional limb perfusion allows drug dose to be reduced while maintaining therapeutic concentrations at
165-431: The intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=RLP&oldid=1159690450 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Limb perfusion Isolated limb perfusion was first introduced into the clinic by American surgeons from New Orleans in
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#1732793106141180-409: The limb. Blood flow through the limb is typically achieved using an extracorporeal circuit consisting of cannulae, tubing, peristaltic roller pump, heat exchanger, and pressure monitoring/safety devices. Care must be used in handling the drugs and waste material as they are extremely toxic. Among other types of cancer, isolated limb perfusion has been used to treat in transit metastatic melanoma. In
195-445: The mid-1950s. The main purpose of the isolated limb perfusion technique is to deliver a very high dose of chemotherapy, at elevated temperature, to tumour sites without causing overwhelming systemic damage. (Unfortunately, while these approaches can be useful against solitary or limited metastases, they are - by definition - not systemic and therefore do not treat distributed metastases or micrometastases ). The flow of blood to and from
210-444: The same condition had no differences in outcome. This suggests that initial RLP treatments should utilize less critically important antimicrobials for initial RLP treatment such a gentamicin, instead of critically important antimicrobials, such as meropenem. In the case of lameness in horses, local use of regenerative therapies, such as stem cells , or bisphosphonates such as tiludronic acid are also given by RLP. In dogs, RLP
225-427: The site of interest, thereby reducing the cost of treatment, localizing application, decreasing systemic side effects, and improving efficacy. Horses are sedated and the procedure is performed standing. Horses must be sedated, because movement can force blood past the tourniquet and reduce the concentration of drug below the site of the tourniquet. The area of needle insertion is clipped and scrubbed. A wide tourniquet
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