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A systematic review of the outcomes of digital sympathectomy for treatment of chronic digital ischemia.

OBJECTIVE
To determine the effectiveness of digital sympathectomy for treatment of chronic digital ischemia, to provide information on outcomes of this surgical procedure, and to give recommendations for further investigations.


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.