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Monthly Health Topic Archive
The University of Chicago Plastic & Reconstructive Program at Weiss specializes in facial plastic surgery, hand surgery, breast reconstruction after breast cancer, breast reduction and augmentation, body contouring, skin cancers and reconstruction for traumatic defects. In addition, Dr. Lawrence Zachary, the Medical Director for the Center has a clinical interest in scleroderma, and is performing digital sympathectomy for Raynaud’s syndrome, often associated with collagen vascular diseases. Our most important goal is to provide patients with individualized care and to help them choose the right procedure for them. For more information, call (773) 564-6120 or visit Plastic & Reconstructive Program.
Lawrence S. Zachary, M.D.
Medical Director, Plastic and Reconstructive Surgery
Weiss Memorial Hospital
Phone: (773) 564-6120
Fax: (773) 564-6121
There are many problems people face with Scleroderma. Major problems can occur with the hands and feet, making daily activities very difficult.
Raynaud's phenomenon is the name given to the disease process when it affects the hands and feet. This phenomenon was first described in 1862 (by Raynaud), for the color changes the hands go through when they are exposed to cold temperature or emotional stress.
The fingers first turn white from lack of blood flow then blue as the blood starts to return because all the oxygen is removed and the color of the blood is dark. Finally, when the blood flow returns completely, the fingers turn red. This problem may not advance to more severe stages although it may progress to constant pain and ulceration leading to loss of tissue or even amputation of fingers or toes.
Medical management can improve the flow of blood to the fingers and toes and relieve many of the symptoms. However, when medical therapy stops working, surgical management can restore blood flow to the fingers and toes.
A microscopic digital sympathectomy is the name of this procedure. To understand the operation, I will briefly discuss how the blood flow to the fingers and toes is affected in Scleroderma. Scleroderma causes the diameter of the vessels to decrease by increasing the thickness of the inside of the blood vessels. Scar tissue is very dense in people with Scleroderma making not only the skin hard but also the underlying tissue stiff, which compresses the vessels decreasing blood flow. The nerves in the fingers and toes send connections to the vessels called sympathetic nerves which, when stimulated, cause the vessels to get smaller in size, decreasing blood flow. A digital sympathectomy divides these nerves going to the blood vessels and removes the scar tissue compressing the vessels. The overall effect is an increase in blood flow to the fingers and toes. The pain is relieved and the ulceration heals.
We have performed this procedure in hundreds of fingers and now have started to do this in toes with very good success. When patients were asked ten years after a microscopic digital sympathectomy if they would do it again and would they recommend this to others, they all said YES. Please call my office at (773) 564-6120 if you would like to learn more, or visit New Hope for Patients with Rare Scleroderma Symptoms.
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