الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 111 |  |  |
| | | from | 111 | | |
Abstract
Digital ischemia is commonly found in patients with vasculitis and has been shown to respond to peripheral digital sympathectomy.) Digital ischemia may be unresponsive to medical therapy. In 2003, Greengrass et al. reported a case of a patient with digital ischemic necrosis having failed medical therapy. The purpose of this study is to report the follow-up of patients with digital ischemia treated with periarterial sympathectomy Longitudinal incision 4 cm (± 1cm) in the radial and ulnar sides at the distal forearm just proximal to the second wrist crease. 4 cm segment of the adventitia was stripped of the radial and ulnar arteries circumferentially.. When digital sympathectomy was needed, two incisions 1.5 cm each were done on medial and lateral aspects of the proximal phalanges of the ischemic fingers.. Exposure and control of the digital vascular-nerve bundle, artery, and collateral digital nerves using 3-time magnifying loop. The adventitia was removed from the digital arteries along the broadest possible path (by gentle dissection) patients were included in the study. The mean and median ages were 33.71 years and 32.00 years, respectively (IQR= 26, 40). The minimum age of the studied patients was 16 years while the maximum age was 73 years. The study included 7 male patients (41%) and 10 female patients (. The minimum duration was one month while the maximum duration was eight. The presenting etiology varied in the study group, 59% vasculitis, 18% micro-embolization (iv drug users), 23% Raynaud’s disease. The mean and median basal VAS scores were 5.06 and 5 respectively (IQR=3, with a range =0-9. After one month, the mean and median VAS scores were 1.88 and 2 respectively (IQR=0.5, 3.5) with a range =0-4. There was a statistically significant difference between the basal VAS score and one-month postoperative VAS score. After six months post-operative, the mean and median VAS scores were 0.82 and zero respectively (IQR=0, 1) with a range There was a statistically significant difference between postoperative one-month VAS score and six months post-operative VAS score. After one month of post-operative follow-up of ulcer, only six patients (35%) showed ulcer compared with 12 patients (71%) who had basal ulcer indicating improvement which was statistically significant. Additionally, six months post-operative follow-up showed that there were no patients complaining of ulcer.