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Capillary nail refill test

Nail blanch test; Capillary refill time

 

The capillary nail refill test is a quick test done on the nail beds. It is used to monitor dehydration and the amount of blood flow to tissue.

How the Test is Performed

 

Pressure is applied to the nail bed until it turns white. This indicates that the blood has been forced from the tissue. It is called blanching. Once the tissue has blanched, pressure is removed.

While the patient holds their hand above their heart, the health care provider measures the time it takes for blood to return to the tissue. Return of blood is indicated by the nail turning back to a pink color.

 

How to Prepare for the Test

 

Remove colored nail polish before this test.

 

How the Test will Feel

 

There will be minor pressure to the bed of your nail. This should not cause discomfort.

 

Why the Test is Performed

 

Tissues need oxygen to survive. Oxygen is carried to various parts of the body by the blood (vascular) system.

This test measures how well the vascular system works in your hands and feet -- the parts of your body that are farthest from the heart.

 

Normal Results

 

If there is good blood flow to the nail bed, a pink color should return in less than 2 seconds after pressure is removed.

 

What Abnormal Results Mean

 

Blanch times that are greater than 2 seconds may indicate:

  • Dehydration
  • Shock
  • Peripheral vascular disease (PVD)
  • Hypothermia

 

 

References

White CJ. Atherosclerotic peripheral arterial disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.

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        Review Date: 4/30/2015

        Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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