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.
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 person 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.
Remove colored nail polish before this test.
There will be minor pressure to the bed of your nail. This should not cause discomfort.
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.
If there is good blood flow to the nail bed, a pink color should return in less than 2 seconds after pressure is removed.
Blanch times that are greater than 2 seconds may indicate:
Swartz MH. The peripheral vascular system. In: Swartz MH, ed. Textbook of Physical Diagnosis. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 12.
White CJ. Atherosclerotic peripheral arterial disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.BACK TO TOP
Review Date: 5/21/2017
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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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