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Administer IV heparin
3%
93/3268
Administer a stellate ganglion block
16%
536/3268
Placement of leeches on the thumb
62%
2016/3268
Inspect the dressing for any constriction
1%
28/3268
Place the thumb in a dependent position.
17%
568/3268
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Arterial thrombosis after digit replantation typically occurs within the first 12 hours postoperatively whereas venous thrombosis/congestion occurs after the first 12 hours postoperatively. Leeches excrete Hirudin, which is 100 times more potent than heparin, but are typically used for the treatment of venous thrombosis/congestion and not arterial thrombosis. Miller's review states a drop in temperature >2 C in 1 hour or temperature below 30 C indicates decreased digital perfusion. If arterial insufficiency develops: release constrictive bandages, place the extremity in a dependent position, consider heparinization, consider stellate ganglion blockade, or explore early if these maneuvers do not work.
3.6
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