Analysis Of Variation Within One Year Of The Nail Fold Microcirculation After Replantation Of Severed Fingers With Different Injury

Background: The current evaluation criteria about restoring blood circulation of replantation was assessed by the subjective feeling of doctors, which was influenced easily from outside and cause errors.Our previous studies have researched the varied regulation about microcirculation of replantation nail, and found that the integration value about nail fold microcirculation of replantation has not yet returned to normal within six months after replantation, However, the reference range which could evaluate restoring blood circulation of replantation according to nail fold microcirculation has not made specific research.This paper use nail microcirculation detector to detect microcirculation of replantation finger because of the cutting and crush injuries within 270 and 365 days, and analyze the variation, then calculate 95% medical reference range of every index.Objective: By comparing the variation of replantation nail fold microcirculation after replantation because of the cutting and crush injuries in 365 days and analysing the differences of nail fold microcirculation between the replantation finger and contralateral healthy finger to look for the specific、objective evaluation criteria of the replantation finger nail fold microcirculation which can provide reference for replantation finger blood circulation restoring in clinic.Methods: Using XW-880 peripheral microcirculation detector and computer analysis system to observe and analyze the changes of nail fold microcirculation after replantation because of the cutting and crush injuries within 270 and 365 days, respectively. Utilizing Niu Tian weighted analysis to compare the difference with the normal. Calculating the difference between the replantation and normal in nail fold microcirculation morphology, flow patterns, Periloop and the total aweighted score, and the mean and standard deviation, then calculate 95% medical reference range(ceiling) of above index. which will be the quantitative reference standard assessing replantation finger blood circulation restoring after replantation because of the cutting and crush injuries.Results:1. The differences were statistically significant between the normal finger and the replantation in the integration of nail fold microcirculation form, flow patterns, Periloop and the total after replantation in the cutting injuries group within 270 and 365 days, respectively(P<0.05);The reference range of the difference of above indexs between the replantation and normal are as follows:(1) The difference of each index is respectively not higher than 1.3,1.2,1.4,3.6 in the cutting injuries group within 270 days;(2) The difference of each index is respectively not higher than 0.8,0.8,0.7,2.1 in the cutting injuries group within 365 days;2. The differences were statistically significant between the normal finger and the replantation in the integration of nail fold microcirculation form, flow patterns, Periloop and the total after replantation in the crush injuries group within 270 and 365 days, respectively(P<0.05);The reference range of the difference of above indexs between the replantation and normal are as follows:(1) The difference of each index is respectively not higher than1.8,1.8,2.0,5.3 in the crush injuries group within 270 days;(2) The difference of each index is respectively not higher than 1.3,1.3,1.4,3.6 in the crush injuries group within 365 days;3. Comparing the replantation in the cutting injuries group in 270 days with the crush injuries in 270 days and 365 days, the difference was statistically significant in the integration of nail fold microcirculation form, flow patterns, Periloop and the total(P<0.05).4. Comparing the replantation in the crush injuries group in 270 days with 365 days,the difference was statistically significant in the integration of nail fold microcirculation form, flow patterns, Periloop and the total.(P<0.05)5. Comparing the replantation in the cutting injuries group in 365 days with the crush injuries in 365 days, the difference was statistically significant in the integration of nail fold microcirculation form, flow patterns, Periloop and the total.(P<0.05)6. The difference in the integration of nail fold microcirculation form, flow patterns, Periloop and the total between the normal fingers of two groups was not statistically significant.(P>0.05)Conclusion: The varied indexes of the replantation nail fold microcirculation after the cutting and crush injuries in 365 days are not still recovered to the normal range. The weighted integral values about the replantation nail fold microcirculation can be applied to essess blood circulation of the replantation,which can make the assessment of the replantation blood circulation become more standard and objective.