A Clinical Study On The Inspection And Analysis Of Nail Fold Microcirculation After Finger Replantation

Objective To study nail fold microcirculation changes after fingerreplantation.Methods Observing nail fold microcirculation changes in23patients at7days post-surgery and40patients at10-15days post-surgery with WX-9A nail foldmicrocirculation detecter color video capture system at room temperature (20-25℃).Compared with the parallel finger on the healthy hand, loop morphology of nail foldmicrocirculation (clarity, loop malformation, the number of the experimentalparameters such as microvasculature loops, the diameter of import branch and exportbranch, capillary top, length of the nailfold capillary loops, loop morphology), bloodflow condition (blood flow velocity, aggregation of erythrocyte), periloop state(microvascular exudativing and bleeding, sub papillary venous plexus, nipple, sweatducts) were detected. Data were analyzed using Professor Tianniu s weighted integralways.Results Detection of fold microcirculation showed the structure ofmicrocirculation was unclear, covered with congestion and exudate, and a strikinginduction of capillary numbers were observed, and microvasculature loops and bloodflow condition were not observed in14patients with replanted finger7days post-surgery. Only one pationt,nailfold microcirculation was clear.For the rest8patients,fold microcirculation was unclear, no microvasculature loop was observed, blood flowshowed a granuliform flow and granular slow flow. Weighted integral value and loopmorphology of replanted fingers at15-20days post-surgery: the weighted integralvalue of replanted finger was1.21, and that of control was0.62. Blood flow condition:replanted finger scored1.31, control scored0.83. Periloop state: replanted fingerscored1.98, control scored1.12. Clearness of the nailfold capillary loops: replantedfinger scored0.68, control scored0.24. Aggregation of erythrocyte: replanted fingerscored1.08, control scored1.02. Loop malformation number: replanted finger scored 1.08, control scored1.02. Microvascular exudativing: replanted finger scored1.72,control scored0.85. A significant disorder of nail fold microcirculation was observedin replated finger compared with control（P<0.01，P<0.05）. Compared with control,the number of microvasculature loops in capillary decreased significantly. Moreover,shorter, thinner and unclear loops, slow blood flow, aggregation of erythrocyte, whiteblood cell around the loops, exudate from loops, decreasing sweat ducts were observed.But loop malformation was not detected.Conclusion (1) Nail fold microcirculation Healing of replanted finger is agradual procedure.(2) After finger replantation, a significant alternation exist in nailfold microcirculation.(3) Nail fold microcirculation detection is an objective methodfor evaluating therapeutic effect of replantation of finger and recovery of function ofreplanted finger, by which a suitable therapeutic project can be selected.