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A Systematic Review of the Outcomes of Digital Sympathectomy for Treatment of Chronic Digital Ischemia
SANDRA V. KOTSIS and KEVIN C. CHUNG
ABSTRACT.
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. (J Rheumatol 2003;30:1788-92) Key Indexing Terms:
SYMPATHECTOMY
From the Section of Plastic Surgery, Department of Surgery, The University of Michigan Health System, Ann Arbor, Michigan, USA. S.V. Kotsis, MPH, Research Associate; K.C. Chung, MD, MS, Associate Professor of Surgery. Address reprint requests to Dr. K.C. Chung, Section of Plastic Surgery, The University of Michigan Health System, 1500 E. Medical Center Drive, 2130 Taubman Center, Ann Arbor, MI 48109-0340, USA. E-mail: kecchung@umich.edu Submitted April 26, 2002; revision accepted January 27, 2003. |