Novel Combined Approach for Digital Necrosis Secondary to Raynaud’s Phenomenon

Author:

Vegas Diego Herrera1ORCID,Fabiani Mario Alejandro2ORCID,Gonzalez-Urquijo Mauricio2ORCID,Bignotti Agustín1,Seré Ignacio1,Salvadores Pablo1

Affiliation:

1. Centro de Estudios Médicos e Investigaciones Clínicas (C.E.M.I.C.), Buenos Aires, Argentina

2. Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo León, México

Abstract

The presence of severe Raynaud’s Phenomenon (RP), with permanent pain or digital necrosis is a rare condition. Cervical sympathectomy or distal sympathectomy or A botulinum toxin have demonstrated efficacy after medical treatment failure. We report the case of a 38-year-old female patient with an acute onset of severe RP in both hands secondary to systemic sclerosis. Medical treatment failed, so a novel approach by a combination of a modified distal sympathectomy and injection of A botulinum toxin on digital neuromuscular bundles was performed. Remission of the pain occurred immediately after the procedure and 45 days later she had complete healing of the digital wounds and recovered full mobilization of both hands. The patient remained asymptomatic 6 month after the procedure, and a Doppler ultrasound showed tri-phasic flows distal to the surgical site. This novel technique is described, and a brief review of the literature is performed.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,General Medicine,Surgery

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. The Use of Botulinum Toxin in Raynaud Phenomenon;Annals of Plastic Surgery;2023-07

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