Reversal of digital vasospasm by glyceryl trinitrate patch

Localized digital ischaemia following tourniquet deflation is an event producing considerable concern after surgical procedures on the hand, and is more common when severe pre-operative deformity has been radically corrected. We describe three such cases of digital ischaemia, occurring immediately after the release of severe flexion contractures of the digits. Our cases were treated successfully by the application of a proximal cutaneous glyceryl trinitrate patch, which produced prompt recovery of the circulation in the affected digits. We suggest that this simple technique has an important role as theraputically, and possibly also as a diagnostic aid, in the evaluation and management of the post-operative ischaemic digit prior to re-exploration being undertaken.