Arterial spasticity and cold intolerance in relation to time after digital replantation

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C Backman1, A Nyström, C Backman

  • 1Department of Hand Surgery, University Hospital of Northern Sweden, Umeå.

Journal of Hand Surgery (Edinburgh, Scotland)
|October 1, 1993
PubMed

Insights

Digital replantation patients experience cold-induced arterial vasospasm, particularly within the first year post-surgery. This vasospasm persists, impacting cold tolerance, but may lessen over two years after digital replantation.

Area of Science:

  • Vascular Surgery
  • Microsurgery
  • Trauma Surgery

Background:

  • Digital replantation aims to restore function after traumatic amputation.
  • Cold intolerance is a common complaint following digital injuries and surgery.
  • Arterial vasospasm can compromise blood flow in replanted digits.

Purpose of the Study:

  • To investigate cold-induced arterial vasospasm in patients undergoing single digit replantation.
  • To assess the temporal changes in vasospasm and its relation to cold tolerance.

Main Methods:

  • Studied ten patients with single digit replantation.
  • Measured finger systolic pressure at varying finger temperatures.
  • Evaluated patients at three time points: within 2 weeks, 1 year, and 3 years post-surgery.

Main Results:

  • Cold-related vasospasm develops within the first year after digital replantation and appears persistent.
  • Subjective cold tolerance is partly attributed to vasospasm, being less severe in patients without pathological vasospasm in the replanted digit.
  • Cold intolerance shows a decreasing trend in the first two years post-replantation but does not fully resolve.

Conclusions:

  • Cold-induced arterial vasospasm is a significant factor affecting cold tolerance in digital replantation patients.
  • Vasospasm is established early and persists long-term, though its impact on cold intolerance may diminish over time.
  • Replantation may mitigate, but not eliminate, cold intolerance associated with digital trauma.

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