Digital Perfusion Assessment
Levinsohn et al (1991)1 demonstrated that the infrared method of as- sessing perfusion was as reliable as Doppler methods, but far less expensive, much faster, and easier to use.
A: | Venous congestion was induced |
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| by placing a 28 mm wide cuff |
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| on the proximal phalanx of the |
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| long finger and then inflating the |
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| cuff to 5 mm Hg above resting |
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| diastolic pressure. With the aid |
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| of a nitrogen pressure regula- |
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| tor, cuff pressure was main- |
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| tained for 60 minutes and as- |
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| sessment of digital perfusion |
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| was performed at 10 minute in- |
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| tervals using: |
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B: | Laser Doppler Flowmetry |
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C: | Pulse Oximetry |
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D: | Skin Surface Fluorescence | Evalutaion of methods of | |
E: | Skin Surface Temperature Mea- | ||
detecting perfusion impairment | |||
| surement via a DermaTemp | ||
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| (Levinsohn et al 1991). |
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Reconstructive Surgery
Despite satisfactory technical replanta- tion, patients may develop vascular per- fusion problems postoperatively, which lead to marginally perfused tissue or to failure. Because any significant change in perfusion is reflected as a change in body surface temperature, temperature measurement is an effec- tive method of monitoring the ongoing viability of replants and flaps1 .
A study by Stirrat et al (1978)2 on the effect of temperature monitoring in digi- tal replantation demonstrated a decline
in perfusion may be recognized earlier via temperature monitoring and improvement gained by clinical measures before the need for reoperation occurs. The objective temperature measurements allow a nurse or nurses aide to follow condition, especially where skin color cannot be followed easily, e.g.
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