Raynaud's phenomenon, digital ulcers and critical digital ischaemia
Raynaud's phenomenon, digital ulcers and critical digital ischaemia
Raynaud's phenomenon, digital ulcers and critical digital ischaemia
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Management of Digital Ulceration<br />
1.<br />
Establish diagnosis early<br />
2.<br />
Treat any contributory cause e.g. infection,<br />
large vessel disease<br />
3.<br />
Optimal wound care <strong>and</strong> analgesia<br />
4. 5. 6.<br />
Optimise oral vasodilators or<br />
IV prostanoids<br />
Consider surgical debridement in<br />
patients with necrotic tissue or<br />
underlying calcinosis<br />
+ +<br />
Antiplatelet <strong>and</strong>/or statin<br />
therapy<br />
Ineffective/recurrent ulceration<br />
7.<br />
Repeat IV prostanoids or PDE5 inhibitor or ERA<br />
Ineffective<br />
8.<br />
Consider <strong>digital</strong> sympathectomy
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