title: Raynaud's phenomenon (secondary).
abstract: BACKGROUND
  Raynaud's phenomenon is episodic vasospasm of the peripheral vessels. It presents as episodic colour changes of the digits (sometimes accompanied by pain and paraesthesia), usually in response to cold exposure or stress. The classic triphasic colour change is white (ischaemia), then blue (de-oxygenation), then red (reperfusion). Raynaud's phenomenon can be primary (idiopathic) or secondary to several different conditions and causes. When secondary (e.g., to systemic sclerosis), it can progress to ulceration of the fingers and toes. This review deals with secondary Raynaud's phenomenon.
  
  
  METHODS
  We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of surgical interventions in complicated secondary Raynaud's phenomenon? We searched: Medline, Embase, The Cochrane Library, and other important databases up to March 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
  
  
  RESULTS
  We found two studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
  
  
  CONCLUSIONS
  In this systematic review, we present information relating to the effectiveness and safety of the following interventions: botulinum toxin, simple debridement/surgical toilet of ulcers, peripheral sympathectomy (digital, digital plus sympathectomy of the ulnar and/or radial artery, ligation of the ulnar artery), cervical/thoracic sympathectomy, arterial reconstruction (venous graft, arterial graft, balloon angioplasty), and amputation.
authors.affiliation: Centre for Musculoskeletal Research, Salford Royal NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Ariane
authors.initials: A
authors.lastname: Herrick
authors.forename: Lindsay
authors.initials: L
authors.lastname: Muir
mesh_terms: D000671:Amputation, Surgical; D001905:Botulinum Toxins / Q000627:therapeutic use; D003646:Debridement; D006801:Humans; D010525:Peripheral Nerves / Q000601:surgery; D011928:Raynaud Disease / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D013562:Sympathectomy; D014456:Ulcer / Q000601:surgery
chemical_list: D001905:Botulinum Toxins