| Objective:Using laser speckle contrast analysis(LASCA)monitor dermal blood perfusion of replanted fingers after operation.To investigate the characteristics and the regular pattern of microcirculation perfusion in early stage after replantation.Trying to set up reference value range of replanted finger's blood perfusion by using laser speckle contrast analysis.And compare the blood perfusion of the replanted fingers between different numbers of anastomosed arteries and between different causes of injury.Method:During Apr.2016 to Sep.2007,152 cases with injury of finger amputation had been hospitalized,112 cases were male,and 40 cases were female,average age were 34.92±15.11 years old.These patients underwent finger replantation operation,116 cases had 1 finger replantation,32 cases had 2 fingers replantation,and 4 cases had 3 fingers replantation,192 replanted fingers in all.All the fingers had good blood circulation after surgery.60 fingers were anastomosed 1 artery during replantation,132 fingers were anastomosed 2 arteries;52 cases with 72 fingers were wounded by similar cutting injury,100 cases with 120 fingers were wound by crush injury.Patients were divided into different groups according to different numbers of anastomosed arteries and different causes of injury.We used PeriCam PSI System to collect blood perfusion data of replanted fingers in the first day to the seventh day after operation.We also collect data of the contralateral corresponding healthy fingers.The devices provide arbitrary perfusion units(PU)to express data.The data were analyzed by statistical software.Results:The means perfusion volume of the replanted fingers in the first day to the seventh day after operation were 88.46±42.27,111.73±55.80,117.47±48.43,116.92 ±54.99,107.34±47.88,112.26 ±52.78,111.95±50.28.Healthy finger perfusion was 180.11±25.71.The 95%confidence intervals of the replanted fingers in the first day to the seventh day after operation were 73.47?103.45,94.12?129.34,102.38?132.56,100?133.85,91.82?122.86,94.40?130.12,93.50?130.39,healthy finger perfusion 95%confidence interval ranged from 167.32 to 190.89.The volume of perfusion in the first day after operation was lower than that of the second day to the fourth day and the sixth day,and there was statistical significance.There was no significant difference between the second and 6 days.All the perfusion volume of the 7 days was significantly lower than that of healthy finger statistically.Perfusion volume of the replantation fingers which were anastomosed the 2 arteries was higher than that of the replantation fingers anastomosed 1 arteries in postoperative days except the fifth day.But there was no significant difference between the two groups with different anastomosed arteries.Perfusion volume of the replantation fingers which were caused by crush injury was higher than that of the replantation fingers which were caused by cutting injury in postoperative days except the third day.There was also no significant difference between the two groups.Conclusion:Laser speckle contrast analysis(LASCA)has the advantages such as non-contact,non-invasive,fast imaging etc.is very suitable for monitoring blood microcirculation.Laser speckle contrast analysis has values in monitoring dermal blood microcirculation of replanted fingers.After replantation surgery,the blood perfusion was worst in the first day,and the perfusion at the early 7 days has a large gap compared with normal finger.There is no obvious uptrend during this period.Anastomosing more arteries in operation cannot enhance perfusion significantly.And cause of injury probably does not affect postoperative perfusion,as long as the amputated fingers have replantation indication and undergo good surgical treatment. |
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