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Cold induced vasospasm in replanted digits: a comparison between different methods of arterial reconstruction
C O Backman1, A Nyström, C Backman
1Department of Hand Surgery, University Hospital of Northern Sweden, Umeå, Sweden.
Summary
Replanted digits often cause cold intolerance. Long arterial grafts may reduce cold-induced arterial spasm, improving outcomes for patients with replanted digits.
Area of Science:
- Orthopedic Surgery
- Vascular Surgery
- Reconstructive Surgery
Background:
- Digit replantation is a complex procedure aimed at restoring function.
- Cold intolerance is a common complication following digital replantation.
Purpose of the Study:
- To evaluate the long-term effects of arterial reconstruction methods on cold intolerance after digit replantation.
- To investigate the relationship between arterial spasm and perceived cold intolerance.
Main Methods:
- Nineteen patients with replanted digits were assessed.
- Arterial reconstruction utilized long grafts, short grafts, or no graft.
- Vascular response to cold was monitored via finger systolic pressure.
- Patients completed questionnaires regarding cold-related symptoms.
Main Results:
- All patients experienced cold intolerance, with improvement in only 60% of cases.
- Longer arterial grafts were associated with fewer pathological arterial reactions to cold.
- Cold-induced arterial spasm in the replanted digit correlated with more severe perceived cold intolerance.
Conclusions:
- Cold intolerance is a persistent issue after digit replantation.
- Long arterial grafts may mitigate cold-induced vasospasm, potentially improving functional outcomes.
- Identifying and managing cold-induced arterial spasm is crucial for patient recovery.