Related Experiment Video
Updated: Jul 13, 2025

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Surgical management of digital ulcers in systemic sclerosis: A systematic literature review
Yossra A Suliman1, Corrado Campochiaro2, Michael Hughes3
1Rheumatology and Rehabilitation Dept, Assiut University Hospital, Assiut, Egypt.
Background:
There is a strong rationale to develop locally-acting surgical treatments for digital ulcers (DUs) in patients with systemic sclerosis (SSc). Our aim was to examine the safety and efficacy of local surgical management for SSc-DU.
Methods:
A systematic literature review was carried out until to August 2022 using 7 different databases. Original research studies concerning adult patients with SSc-DUs, and local surgical treatments were analysed using the PICO framework. We included randomized controlled trials, prospective/retrospective studies, and case series (minimum of 3 patients) References were independently screened by two reviewers including assessment of the risk of bias using validated tools.
Results:
Out of 899, 13eligible articles were included. Autologous fat (adipose tissue AT) grafting was the surgical modality most identified (7 studies, 1 randomized controlled double blinded trial and 6 prospective open-label single arm studies). The healing rate (HR) with autologous fat grafting (4 studies) was 66-100 %. Three studies reported autologous adipose-derived stromal vascular fraction grafting: HR of 32-60 %. Bone marrow derived cell transplantation in a single study showed 100 % healing rate over 4-24 weeks. Surgical sympathectomy was examined in 3 studies, prospective without comparator with a median healing rate of 81 %. Two surgical studies (of direct microsurgical revascularisation and microsurgical arteriolysis) showed 100 % healing of ulcers, with no complications.
Conclusion:
Several surgical approaches for SSc-DUs have demonstrated some degree of safety and effectiveness for DU healing. However, there are significant methodological issues. Future studies are warranted to rigorously investigate surgical interventions for SSc-DUs.
More Related Videos
Related Concept Videos
Peripheral Artery Disease IV: Nursing Management
Peripheral Artery Disease V: Postoperative Nursing Management
Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
Varicose Veins II: Diagnostic Studies and Interprofessional Care
Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
Peripheral Artery Disease III: Interprofessional Care

