Evaluation of a replanted finger and measuring its perfusion changes to predict its viability by laser speckle contrast imaging

Abstract

Background: This research aims to monitor the microcirculation of the replanted finger, which was entirely severed by using laser speckle contrast imaging (LSCI) for early detection and revision of vascular compromise for successful finger replantation.

Methods: These six months of research was taken for a survey of 40 cases of replanted fingers of patients of distinct ages and sex. Scrutinizing was done postoperatively by LSCI, every hourly for seven days, to assess changes in blood perfusion both in replanted fingers and healthy ones and analyzed graphically.  

Results: Initially, from postoperative d=0 to d=2, the perfusion value was at baseline, which ranged 40±15 perfusion unit (PU), showing a wave-like curve, then gradually increased up to 350±50 PU or above in case of those which survived successfully, showing continuous peak slope. However, a gradual drop in perfusion, <35 PU from d=2 or d=3, was seen in those despite undergoing heparinized finger pin-prick bleeding therapy and failed to thrive, showing a downslope curve. Whereas some were under meticulous observation, which flourished lately. Concurrently, a comparison was made with the healthy fingers’ of the same patient, ranging from 200±50 to as high as 400±50 or above. Clinical correlation, as well as perfusion readings of LCSI, were done simultaneously.

Conclusions: LSCI provides sensitive and reproducible finger microcirculation measurements and is reliable in predicting reductions in blood perfusion induced by venous or arterial occlusion. It is, therefore, an informative device to detect microvascular compromise during and after replantation surgery.