Nail fold capillary observation in replanted severed fingers

Abstract

Observation of circulation in replanted severed fingers often relies on the clinical experience of the doctor. This article discusses nail fold capillary loops (NFCL) observation in the monitoring of the perfusion and circumfluence of replanted digits. In our study, 30 patients with a total of 39 replanted digits were selected. The WX‐9A900 Microcirculation Checkout System (MCS) was adopted to perform evaluation of circulation postoperatively. The digits were monitored by clinical examination and MCS at 5‐ to 7‐h intervals for 24 h and then at 2‐days intervals for 14 days. Our results showed that seven digits were observed with inadequate venous circumfluence, and large, long NFCL presented within 6–12 h postoperatively. Among the replanted digits, two replants resulted in venous crisis that did respond to an arterial interdiction test, and needed venous grafts. Two digits were observed to have insufficient arterial supply, one of which resulted in arterial crisis. In this case, NFCL could not be observed and had no response to vein interdiction test. This case needed venous graft to rebuild blood perfusion, and survived eventually. We concluded therefore, that compared with the former studies, NFCL correlates closely with the perfusion and circumfluence of the replanted digits. MCS is noninvasive, reliable, and a direct method in postoperative monitoring of digit replanted. © 2008 Wiley‐Liss, Inc. Microsurgery, 2008.