Use of nailfold capillaroscopy for the assessment of patients undergoing digit replantation
Methodology study published in Jt Dis Relat Surg (2024)
Abstract
OBJECTIVES: In this study, we aimed to evaluate microvascular changes using nailfold capillaroscopy in patients who underwent digit replantation and revascularization. PATIENTS AND METHODS: A total of 46 patients (34 males, 12 females; mean age: 45.8±17.6 years; range, 18 to 75 years) who underwent replantation or revascularization procedures between February 2012 and May 2023 were retrospectively analyzed. Nailfold capillaroscopy images were assessed for various parameters including capillary count, diameter, dilatation, presence of giant capillaries, capillary disarrangement, microhemorrhages, neoangiogenesis, subpapillary plexus appearance, crossing capillaries, tortuosity, and microaneurysm. We investigated the association between microvascular alterations and clinical outcomes. RESULTS: Of 46 patients, 25 patients underwent replantation and 21 patients underwent revascularization. Significant microvascular changes, including subpapillary venous plexus, microvascular enlargement, microhemorrhages, neoangiogenesis, and tortuosity were observed in replantation patients (p=0.000b, p=0.020, p=0.021b, p=0.001, and p=0.004, respectively). However, these changes were not significant in revascularization patients. Revascularization patients exhibited an increase in capillary diameter and disarrangement (p=0.019 and p=0.016b, respectively). A significant negative correlation existed between digital nerve repairs and microvascular enlargement in replantation patients. Hyperesthesia was significantly correlated with neoangiogenesis and capillary disarrangement, while a statistically significant positive relationship was found between subpapillary venous plexus and patient satisfaction in replantation patients. CONCLUSION: Our study showed that replantation patients who underwent two nerve repairs exhibited a well-regulated microvascular tone. However, we did not observe a statistically significant relationship between the number of nerve repairs and cold intolerance. Based on these findings, we highlight the potential of nailfold capillaroscopy in detecting microvascular changes following replantation and revascularization, which may contribute to a better understanding of the etiology of neurovascular complications.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Methodology study of nailfold capillaroscopy as assessment tool for patients undergoing digit replantation.
Why This Matters for Hirudotherapy
This retrospective study analyzed 46 patients who underwent digit replantation or revascularization, using nailfold capillaroscopy to assess postoperative microvascular changes. Significant findings in replantation patients included subpapillary venous plexus, microvascular enlargement, microhemorrhages, neoangiogenesis, and tortuosity, while revascularization patients showed increased capillary diameter and disarrangement. The abstract makes no mention of leeches, hirudotherapy, hirudin, or any leech-derived intervention. No defensible connection to ASH's domain exists based on the abstract provided; the study is focused entirely on microvascular assessment using capillaroscopy following reconstructive hand surgery.
Citation
Use of nailfold capillaroscopy for the assessment of patients undergoing digit replantation.
Koroglu et al. · Joint diseases and related surgery, 2024
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