The perfusion index as a noninvasive method for monitoring revascularized and replanted digits
Issue title: Selected articles from the 3rd Joint Meeting of The European Society for Clinical Hemorheology and Microcirculation (ESCHM) , The International Society for Clinical Hemorheology (ISCH) and The International Society of Biorheology (ISB), Regensburg, Germany, 28 – 30 September 2023
Guest editors: L. Prantl, A. Krueger-Genge and F. Jung
Affiliations: [a] Department of Trauma Surgery, Orthopedics, Plastic and Hand Surgery, University of Augsburg, Augsburg, Germany
| [b] Department of Plastic, Hand and Reconstructive Surgery, University of Regensburg, Regensburg, Germany
Correspondence:
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Corresponding author: Catharina Strauss, University of Augsburg, Department of Trauma surgery, Orthopedics, Plastic and Hand Surgery, Stenglinstrasse 2, 86155 Augsburg, Germany. E-mail: catharina_strauss@hotmail.com.
Abstract: BACKGROUND:Monitoring replanted digits remains a challenging task in microsurgical units. Previous studies have indicated the perfusion index (PI), a parameter directly proportional to the blood flow, might be a useful tool. OBJECTIVE:The PI is evaluated as a monitoring tool in patients with replanted digits. METHODS:This prospective, non-interventional study includes 31 patients with revascularized or replanted digits. After successful revascularization or replantation, the PI and peripheral oxygen saturation of the affected finger and its contralateral equivalent were measured simultaneously. The values were detected by the device Radical-97® Pulse CO-Oximeter® (Masimo Corporation, 52 Discovery, Irvine, CA 92618, USA). RESULTS:The median PI of affected fingers was 3.5±0.56 for revascularized and 2.2±0.8 for replanted fingers. The difference between the PI values of replanted digits and the healthy contralateral side was highly significant (p < 0.0001). The area under the curve in the receiver operating characteristics was 0.92 for a PI difference > 80.49% and predicted a loss of replant with a specificity of 100% and a sensitivity of 75%. CONCLUSION:The assessment of the PI in patients with reperfusion of a vascular compromised digit is a useful tool to continuously monitor peripheral perfusion. The dynamic behavior of the PI is essential to detect perfusion disturbance.
