CLINICAL-EVALUATION AND TEMPERATURE MONITORING IN PREDICTING VIABILITY IN REPLANTATIONS

Experiences with temperature and clinical monitoring in a series of 11 1 patients with 188 revascularized digits were reviewed. Criteria for abnormal temperature monitoring were defined. Monitoring of only clini cal parameters showed a sensitivity of 1.00 and specificity of .97, bu t this technique was time-consuming and required experienced interpret ation of subtle clinical changes. Temperature monitoring gave a sensit ivity of 1.00, while the specificity was only 61. Drops in temperature were frequently not associated with vascular problems. Review of digi ts with abnormal clinical or temperature monitoring showed five patter ns of abnormality. The first three groups had either abnormal clinical or temperature monitoring, but all fingers survived without reexplora tion. The fourth and fifth groups showed abnormalities in both clinica l and temperature monitoring; all but one finger were found to be nonv iable. Combined clinical and temperature monitoring was highly effecti ve in early prediction of vascular compromise, with a sensitivity of 1 .00 and a specificity of .99. The authors recommend the use of tempera ture monitoring. If a temperature drop occurs, monitoring of the clini cal parameters can then be done. If both temperature and clinical moni toring yield abnormal results after a specified time, intervention sho uld be carried out.