[Admittance plethysmographic study of the recovery of vasomotor function in replanted fingers]

A new admittance plethysmograph, designed for the observation of finger vasomotor function, was employed to characterize circulation through replanted fingers and to clarify the relationship between the duration of ischemia and the postoperative recovery of finger sensory function. The study was carried out on 13 replanted fingers, 1 replanted arm and 12 contralateral normal fingers of 11 patients who underwent finger or arm replantation. To assess the reliability of this admittance plethysmograph, water-filled plethysmography was simultaneously performed, utilizing a newly devised electric volume sensor. Replanted fingers were divided into three groups based on vasomotor reactions; normal reaction group, vasodilation group and vasoconstriction group. This classification of vasomotor reactions had a high correlation ratio (0.86) with static two-point discrimination (2PD). Total ischemia time (time from amputation to reperfusion) did not correlate with static 2PD, while total warm ischemia time (obtained by subtracting the duration of cold storage of amputated finger from the total ischemia time) correlated well with static 2PD (gamma s = 0.766). The finding of various types of vasomotor reactions in replanted fingers suggests that normal vasomotor function cannot be restored by recovery of vasoconstrictor nerves alone, and that vasodilator nerves are also present in hands and fingers.