Avtor/Urednik		Planinšek, Franci; Arnež, Zoran Marij
Naslov		Vpliv kajenja na kožno temperaturo replantiranih in zdravih prstov
Prevedeni naslov		The influence of smoking on skin temperature in replanted and healthy digits
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 35, št. Suppl 2
Leto izdaje		1996
Obseg		str. 221-30
Jezik		slo
Abstrakt		The opinion that smoking or any other type of tobacco use in the early postoperative period after a microsurgical procedure is a factor of risk for the development of a coagulum at the place of anastomosis is widely accepted. It is known that nicotine increases the tone of peripheral blood vessels in normal tissues and also in replanted digits for several months after a surgical procedure. Arterial spasms in the skin are predominantly neurogenically mediated. In a replanted digit or in free transfer of tissue, all blood vessels are entirely denervated in the early phase. The purpose of this study was to establish the response of denervated blood vessels to smoking. The study included nine patients, smokers, after traumatic amputation of one or more digits. Skin temperatures of the replanted and the corresponding healthy digit were measured with a digital thermometer equipped with a semicon ductor. The statistical analysis was comprised of 5 minute periods both before and after smoking. After smoking, a statistically significant reduction in the temperature of the healthy digit by 0.77 degree C (p=0.023) occurred. In the replanted digit, the temperature was reduced only by 0.08 degree C. This reduction was insignificant (p=0.13). During smoking, the temperature of the replanted digit was on average 0.94 degree C lower (p=0.022) than the temperature of the corresponding digit. The temperature of digits replanted using a blood vessel transplant and a proximal anastomosis on the dorsal branch of the radial artery was higher by 0.61 degreeC (p < 0.05) than the temperature of digits replanted with direct anastomosis of the digital artery. It seems that the use of tobacco in the early postoperative period is not a risk factor for vascular spasms in the area of the anastomosis of the replanted digit or freely transferred tissue. (Abstract truncated at 2000 characters.)
Izvleček		Velja prepričanje, da je kajenje ali kakršnakoli druga uporaba tobaka v zgodnjem pooperativnem obdobju po mirokirurškem posegu dejavnik tveganja za razvoj spazma ali krvnega strdka na mestu anastomoze. Znano je, da nikotin zviša tonus perifernega žilja v normalnem tkivu, enako tudi v replantiranih prstih več mesecev po kirurškem posegu. Spazem kožnih arterij je pretežno živčno posredovan. V replantiranem prstu ali ob prostem prenosu tkiva so v zgodnji fazi vse žile popolnoma denervirane. Namen raziskave je bil ugotoviti odgovor denerviranega žilja na kajenje. V študijo smo vključili devet bolnikov kadilcev po travmatski amputaciji enega ali več prstov. Kožno temperaturo replantiranega in simetričnega zdravega prsta smo merili z digitalnim termometrom s polprevodnikom. V statistično analizo je bilo zajeto obdobje 5 minut pred kajenjem in 5 minut po njem. Po kajenju smo ugotovili značilno znižanje temperature na zdravem prstu za 0,77 degrees C (p = 0,023). Na replantiranem prstu se je temperatura znižala le za 0,008 degrees C. Znižanje ni bilo značilno (p = 0,13). Temperatura replantiranega prsta pred kajenjem je bila v povprečju nižja od temperature simetričnega zdravega prsta za 0,94 degrees C (p = 0,022). Temperatura replantiranega prsta z uporabo žilnega presadka in proksimalno anastomozo na dorzalni veji arterije radialis je višja od temperature replantiranega prsta z direktno anastomozo digitalne arterije za 0,61 degrees C (p < 0,05). Ugotavljamo, da uporaba tobaka v zgodnjem pooperativnem obdobju ni dejavnik tveganja za nastanek spazma žil v predlu anastomoze replantiranega prsta ali prosto prenesenega tkiva. V primeru arterijskih motenj prekrvitve replantiranega prsta in posledičnega zmanjšanja njegove temperature uporaba simpatikolitikov ni smiselna.
Deskriptorji		SKIN TEMPERATURE SMOKING REPLANTATION FINGER INJURIES BLOOD PRESSURE