{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:38:27Z","timestamp":1776213507373,"version":"3.50.1"},"reference-count":54,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\u00a0and Clinical Significance: 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. Case presentation: 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 Aspergillus 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. Conclusions: 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.<\/jats:p>","DOI":"10.3390\/diagnostics15060688","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T08:59:52Z","timestamp":1741683592000},"page":"688","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lactate Levels in a Replanted Limb as an Early Biomarker for Assessing Post-Surgical Evolution: A Case Report"],"prefix":"10.3390","volume":"15","author":[{"given":"Alina","family":"Belu","sequence":"first","affiliation":[{"name":"Department of Morphofunctional Sciences I\u2014Pathology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4192-3704","authenticated-orcid":false,"given":"Viorel","family":"\u021aarc\u0103","sequence":"additional","affiliation":[{"name":"Department of Preclinical Disciplines, Faculty of Medicine, Apollonia University, Strada P\u0103curari nr. 11, 700511 Ia\u0219i, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0949-7538","authenticated-orcid":false,"given":"Nina","family":"Filip","sequence":"additional","affiliation":[{"name":"Department of Morphofunctional Sciences II\u2014Biochemistry, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Ia\u015fi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3018-8011","authenticated-orcid":false,"given":"Elena","family":"\u021aarc\u0103","sequence":"additional","affiliation":[{"name":"Department of Surgery II\u2014Pediatric Surgery, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8326-7610","authenticated-orcid":false,"given":"Laura Mihaela","family":"Trandafir","sequence":"additional","affiliation":[{"name":"Department of Mother and Child\u2014Pediatrics, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodica Elena","family":"Heredea","sequence":"additional","affiliation":[{"name":"Department I Nursing, Discipline of Clinical Practical Skills, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 300041 Timi\u015foara, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silviana","family":"Chifan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana Elena","family":"Parteni","sequence":"additional","affiliation":[{"name":"Department of Morphofunctional Sciences I\u2014Pathology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Bernic","sequence":"additional","affiliation":[{"name":"Discipline of Pediatric Surgery, \u201cNicolae Testemi\u021banu\u201d State University of Medicine and Pharmacy, MD-2001 Chisinau, Moldova"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7859-840X","authenticated-orcid":false,"given":"Elena","family":"Cojocaru","sequence":"additional","affiliation":[{"name":"Department of Morphofunctional Sciences I\u2014Pathology, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1055\/s-0039-1696733","article-title":"Amputations versus Salvage: Reconciling the Differences","volume":"37","author":"Black","year":"2021","journal-title":"J. Reconstr. Microsurg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.otsr.2017.05.022","article-title":"Is amputation a viable treatment option in lower extremity trauma?","volume":"103","author":"Barla","year":"2017","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/j.bjps.2012.11.026","article-title":"Delayed amputation following trauma increases residual lower limb infection","volume":"66","author":"Jain","year":"2013","journal-title":"J. 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