ABSTRACT
Experiences with temperature and clinical monitoring in a series of 111 patients with
188 revascularized digits were reviewed. Criteria for abnormal temperature monitoring
were defined. Monitoring of only clinical parameters showed a sensitivity of 1.00
and specificity of .97, but this technique was time-consuming and required experienced
interpretation of subtle clinical changes. Temperature monitoring gave a sensitivity
of 1.00, while the specificity was only .61. Drops in temperature were frequently
not associated with vascular problems.
Review of digits with abnormal clinical or temperature monitoring showed five patterns
of abnormality. The first three groups had either abnormal clinical or temperature
monitoring, but all fingers survived without reexploration. The fourth and fifth groups
showed abnormalities in both clinical and temperature monitoring; all but one finger
were found to be nonviable.
Combined clinical and temperature monitoring was highly effective in early prediction
of vascular compromise, with a sensitivity of 1.00 and a specificity of .99. The authors
recommend the use of temperature monitoring. If a temperature drop occurs, monitoring
of the clinical parameters can then be done. If both temperature and clinical monitoring
yield abnormal results after a specified time, intervention should be carried out.
