title: Post-traumatic Digital Gangrene Associated with Epinephrine Use in Primary Raynaud's Phenomenon: Lesson for the Future.
abstract: BACKGROUND
  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 such conditions, post-operative ischaemic changes may be further exacerbated with the use of local anaesthetics in combination with epinephrine.
  
  
  METHODS
  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 laceration which 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 primary Raynaud's Phenomenon (RP).
  
  
  CONCLUSIONS
  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 how primary RP can be complicated by gangrene.
authors: Galactic Corps Research Group (GCRG) and Department of Clinical Sciences, Faculty of Health Sciences, University of Buea, Buea, South-West Region, Cameroon.
authors: Carlson-Babila
authors: CB
authors: Sama
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects* / Q000379:methods; D000758:Anesthesia / Q000009:adverse effects* / Q000379:methods; D004837:Epinephrine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005385:Fingers / Q000473:pathology* / Q000601:surgery; D005734:Gangrene / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D022125:Lacerations / Q000601:surgery*; D011928:Raynaud Disease / Q000150:complications* / Q000175:diagnosis; D014661:Vasoconstriction; D014662:Vasoconstrictor Agents / Q000009:adverse effects; D055815:Young Adult
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine
keywords: Digital gangrene; Raynaud's phenomenon; epinephrine; trauma