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Nail fold capillary observation in replanted severed fingers
Wei Lu1, Daping Wang, Lijun Liu
1Department of Traumatic and Hand Surgery, Southern Medical University Shenzhen Hospital, Shenzhen, Guangdong, China. winerlu@hotmail.com
Microsurgery
|January 4, 2008
Summary
Nail fold capillary loops (NFCL) observation effectively monitors blood flow in replanted digits. This method, alongside the Microcirculation Checkout System (MCS), aids in early detection of circulation issues, improving replant survival rates.
Area of Science:
- Microsurgery
- Vascular Surgery
- Regenerative Medicine
Background:
- Postoperative monitoring of replanted digits traditionally relies on clinical judgment.
- Assessing perfusion and circumfluence in replanted digits is critical for successful outcomes.
- Objective, noninvasive methods are needed to supplement clinical assessment.
Observation:
- Nail fold capillary loops (NFCL) were observed in 39 replanted digits across 30 patients.
- The WX-9A900 Microcirculation Checkout System (MCS) was used for postoperative circulation evaluation.
- Monitoring occurred at frequent intervals for 24 hours, then bi-daily for 14 days.
Findings:
- Large, elongated NFCL appeared within 6-12 hours in digits with inadequate venous return (7 cases).
- Two cases of venous crisis, responsive to arterial tests, required venous grafts.
- Insufficient arterial supply (2 cases) led to arterial crisis, where NFCL were absent and unresponsive to venous tests, necessitating venous grafts.
Implications:
- NFCL observation is a reliable indicator of blood perfusion and circulation in replanted digits.
- The Microcirculation Checkout System (MCS) provides a noninvasive, direct method for postoperative monitoring.
- Early detection of circulatory compromise through NFCL and MCS can guide timely interventions, improving replant viability.
