Paradoxical response to water immersion in replanted fingers

Abstract

When the fingers are immersed in water digital blood flow is reduced and the skin wrinkles, suggesting that vasoconstriction plays a role. However, is wrinkling due to sympathetic activation or some intrinsic property of the skin? To define the role of autonomic innervation in skin wrinkling we measured changes in blood perfusion (Laser Doppler Perfusion Imager) in 20 successfully replanted fingers (mean time after complete amputation 17.5 +/- 5.2 months). We compared responses in replanted fingers with those in corresponding contralateral normal fingers before and immediately after immersion in saline (0.5 mol/l NaCl at 40 degrees C). In the normal fingers, immersion caused a decrease in blood flow by 27.6 +/- 11.5% and skin wrinkling. However, in the replanted fingers blood flow increased by 22.8 +/- 19.6% and the skin did not wrinkle. The paradoxical cutaneous vasodilatation and absence of wrinkling in the denervated fingers suggests that sympathetic innervation is important in water-immersion skin wrinkling.

EMLA and Water Immersion Cause Similar Vasodilatation in Replanted Fingers

“…O'Riain has reported that replanted fingers are unable to demonstrate wrinkling after water immersion (O'Riain's sign) [14]. In our previous study using laser Doppler perfusion imaging, we demonstrated significant vasodilatation accompanied by no wrinkling in replanted fingers following immersion, implying poor sympathetic innervation after replantation [15]. The present study aimed to clarify the effect and mechanism of action of EMLA on digital venoarteriolar response by investigating the change in digital perfusion after application of EMLA to replanted fingers and contralateral corresponding normal fingers.…”

Fingerprint recognition system performance in the maritime environment

“…A wrinkled finger affected by pruning is often referred to as a pruney or water aged finger [3]. Figure 1 is an example of a water aged finger of a baby after a warm bath [4].…”

Free Flow of Sweat due to Loss of Surface Tension at Sweat Droplet Causes Water-Induced Skin Wrinkling

“…Because of the non-functioning sympathetic nerves, vasoconstriction and skin wrinkling will be absent in the denerved fingers. Observation of vasodilation in denereved fingers by Hsieh et al [18], when immersed in water, supports the case for increased sweating. It was also observed that EMLA cream cause similar dilation when applied to denerved fingers [19].…”