Post-traumatic Digital Gangrene Associated with Epinephrine Use in Primary Raynaud’s Phenomenon: Lesson for the Future
ABSTRACTBACKGROUND: Following digital surgical procedures, the ensuing post-operative course may be complicated by the presence of underlying ischaemic or vasospastic process. In the presence of suchconditions, post-operative ischaemic changes may be further exacerbated with the use of local anaesthetics in combination with epinephrine.CASE DETAILS: We report a 21 year-old female who presented with an amputated fifth digit due to a rapidly spreading gangrene which started immediately after the surgical repair of a traumatic lacerationwhich was infiltrated with a pre-mixed solution of lignocaine and epinephrine 3 hours earlier. The patient’s final diagnosis was epinephrine-associated digital gangrene in the background of primaryRaynaud’s Phenomenon (RP).CONCLUSION: The author reports this case in order to reiterate the importance of thorough clinical evaluation prior to the use of epinephrine in digital anaesthesia as well as to increase awareness on howprimary RP can be complicated by gangrene.KEYWORDS: Digital gangrene, trauma, epinephrine, Raynaud’s phenomenonDOI: http://dx.doi.org/10.4314/ejhs.v26i4.13