Hemodynamic studies of digital and extremity replants and revascularizations

Blood pressure, blood flow, skin temperature, pulse contour, and sympathetic nerve activity were investigated by noninvasive methods in 33 fingers, five arms, and one foot that had been replanted or revascularized 2 to 30 months previously. Results from the operated parts were contrasted with those from the same part on the contralateral normal extremity and with those obtained from normal controls. Mean blood pressure in operated fingers (97 +/- 18 mm Hg) was significantly lower than that in nonoperated (114 +/- 16 mm Hg) and control (115 +/- 17 mm Hg) fingers. Mean blood flow in operated fingers (16 +/- 100 ml/100 ml/min) was significantly less than that in nonoperated (23 +/- 11 ml/100 ml/min) and control (28 +/- 20 ml/100 ml/min) fingers. In 80% of the studies, blood pressure and blood flow were less on the operated side than on the nonoperated side; however, 75% of the blood pressure determinations and all of the blood flows fell within the 95% confidence limits of the control values. Skin temperatures were not decreased and sympathetic activity had returned in 91% of the fingers. It is concluded that the perfusion of tissues surviving replantation or revascularization usually is within normal limits but often is reduced when compared to that of normal tissues of the same individual.