Peri-operative swelling of fingers

Abstract

BACKGROUND In most Dutch hospitals, because of putative peri-operative swelling of the fingers, patients must remove rings before entering the operating theatre. If this proves impossible, destructive methods for removal may be required. For some patients, this might be too radical, as the risk of wearing rings may not be in proportion to the economic and emotional damage to the patient. OBJECTIVE The objective of this study was to determine whether peri-operative swelling of fingers occurs in elective surgery patients. DESIGN A prospective observational study. SETTING University Medical Centre. PATIENTS Five groups of patients: major cardiothoracic surgery, major noncardiothoracic surgery, nonmajor surgery with a minimum of one overnight stay, nonmajor surgery without overnight stay and surgery under intrathecal anaesthesia. MAIN OUTCOME MEASURE Finger swelling, as measured by the circumference of the first phalanx of the middle and ring fingers of both hands, pre-operatively and at 3, 24 and 48 h postsurgery, using a roller tape with one winding and 20-g weights in a custom-made frame. RESULTS One hundred and forty-eight patients were enrolled. Peri-operative swelling reached statistical significance in all groups and was most prominent in major cardiothoracic and noncardiothoracic surgery (maximum increases in circumference were 10.6 and 7.3%, respectively). In all groups, maximal swelling was observed 24 h postsurgery. CONCLUSION Peri-operative swelling of fingers is a common phenomenon, which is related to the extent of the surgical procedure. TRIAL REGISTRATION Netherlands Trial Register NL8066.