Atorvastatin and nitroglycerin ointment in digit replantation: Associations with vascular crisis and circulating biomarkers

Vascular crisis is a major threat to digit replantation success, leading to substantial failure rates and compromised functional recovery.

To assess the association of combined atorvastatin and nitroglycerin ointment with vascular crisis, circulating biomarkers and clinical outcomes in patients undergoing unilateral digit replantation.

184 patients were prospectively allocated to combination (atorvastatin + nitroglycerin) or control (nitroglycerin alone) groups. Vascular crisis incidence, serum biomarkers (TNF-α, IL-6, CRP, NO, eNOS, ET-1), microcirculation indices and 30-day digit survival were systematically monitored.

Combination therapy decreased vascular crisis incidence (6.52% vs. 16.30%, P=0.037) and improved 30-day digit survival (90.22% vs. 79.35%, P=0.040). Postoperatively, the combination group exhibited lower levels of TNF-α, IL-6, CRP and ET-1, along with higher NO/eNOS levels and improved microcirculation, with all differences statistically significant after Bonferroni correction (P<0.05).

Atorvastatin combined with nitroglycerin ointment correlates with reduced vascular crisis and favorable 30-day outcomes, accompanied by beneficial shifts in biomarkers and microcirculation that may underpin the therapeutic effects.