1 research outputs found
A black finger does not equal a dead finger
Revascularisation and replant surgery occasionally produces sub-optimal results.
We present two cases of near total amputation of the digits. The first patient
was an 11-year-old boy with a middle finger avulsion injury sustained after the
finger was caught in a washing machine with the flexor digitorum profundus still
attached. The second patient was a 42-year-old male who sustained a machete
attack and had near total amputation of his small and ring fingers with a 2 cm skin
bridge still attached. All patients underwent revascularization with repair of only
one digital artery for each finger as the opposite artery was non-viable. No digital
veins were repaired. Relief of venous congestion was done by pin-prick six times
a day up till one week. At one week post-surgery, the fingers were discoloured
black but had good pulp turgor and full contour with arterial bleed on pin-prick.
Inexperienced surgeons may view this as gangrene and amputate the fingers.
However, we continued observation and at one month post-surgery, the black
skin had desloughed and the underlying skin was pink