Sandra V Kotsis1, Kevin C Chung. 1. Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System, Ann Arbor, Michigan, USA.
Abstract
OBJECTIVE: To determine the effectiveness of digital sympathectomy for treatment of chronic digital ischemia, to provide information on outcomes of this surgical procedure, and to give recommendations for further investigations. METHODS: We conducted a systematic review of English language citations referring to digital sympathectomy published between 1966 and 2002 using Premedline and Medline. RESULTS: Multiple differences in surgical techniques, causes of digital ischemia, and outcome measurements among studies made comparisons of surgical outcomes difficult. We found that 14% of all patients required amputation and 18% of patients had ulcer recurrence. Some type of postoperative complication was reported in 37% of patients with systemic sclerosis. CONCLUSION: To best determine the effectiveness of this surgical procedure, we recommend that future studies are prospective, to include standardized pre- and postoperative measurements, stratify the study outcomes by diagnosis and disease duration, and have consistent postoperative followup intervals.
OBJECTIVE: To determine the effectiveness of digital sympathectomy for treatment of chronic digital ischemia, to provide information on outcomes of this surgical procedure, and to give recommendations for further investigations. METHODS: We conducted a systematic review of English language citations referring to digital sympathectomy published between 1966 and 2002 using Premedline and Medline. RESULTS: Multiple differences in surgical techniques, causes of digital ischemia, and outcome measurements among studies made comparisons of surgical outcomes difficult. We found that 14% of all patients required amputation and 18% of patients had ulcer recurrence. Some type of postoperative complication was reported in 37% of patients with systemic sclerosis. CONCLUSION: To best determine the effectiveness of this surgical procedure, we recommend that future studies are prospective, to include standardized pre- and postoperative measurements, stratify the study outcomes by diagnosis and disease duration, and have consistent postoperative followup intervals.