A review of the literature on shellfish depuration and relaying revealed wide diversity in microbial uptake and elimination among shellfish species and for different microorganisms. Information on relaying of five commercial shellfish species and on controlled purification (depuration) of 11 species indicates that such processes are effective in reducing the levels of bioconcentrated bacteria and viruses from shellfish. The degree of bacterial and viral bioconcentration varies with shellfish species; however, the primary sites of bioconcentration are the hepatopancreas and digestive diverticula. Low levels of enteric viruses and coliphage may be sequestered in shellfish hemolymph and tissues, thus protecting them from elimination through depurative processes. Vibrio spp. appear to proliferate when closely associated with intestinal cells of shellfish. Shellfish relaying techniques offer effective microbial depletion provided water quality is acceptable and shellfish remain physiologically active. The current body of literature on controlled purification demonstrates a broad spectrum of conditions under which shellfish are depurated. Optimal times, temperatures and salinities for effective depuration vary among shellfish species. Proper design and operation of depuration plants is crucial to insure process integrity. Recirculating and flow-through purification systems are effective in reducing the levels of pathogenic and indicator microorganisms from shellfish, but the extent to which they reduce viruses from shellfish is uncertain. Studies are needed to validate the effectiveness of depuration processes in eliminating pathogenic viruses and to address the adequacy of indicator bacteria as measures of enteric virus contamination.
Arterialized Venous Flow-Through Flaps in the Reconstruction of Digital Defects: Case Series and Review of the Literature
