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June 24, 1988

Jessica in the Well: Ischemia and Reperfusion Injury

Author Affiliations

Midland, Tex

Midland, Tex

JAMA. 1988;259(24):3558-3559. doi:10.1001/jama.1988.03720240020017

To the Editor.  —As one of the specialists attending to Jessica McClure after her dramatic rescue from the open water well in Midland, Tex, I feel a response to Dr Benke's1 letter is indicated. The night Jessica was removed from the well, she was found to have compromised circulation to the right lower extremity from just below the ankle and further distally. This was an ischemic injury caused by compression. Our immediate concerns, of course, were hydration and correction of metabolic acidosis. We were dealing with acute peripheral posttraumatic ischemia and we were worried about the survival of the right foot and possible compartment syndrome within the right foot.Her condition was too unstable to proceed with early surgical intervention; because of studies indicating that hyperbaric oxygen was helpful in compartment syndromes,2 we proceeded with this therapy.In the early morning hours of the first day of her