scholarly journals Ischaemic wound complications in above-knee amputations in relation to the skin perfusion pressure

1980 ◽  
Vol 4 (2) ◽  
pp. 81-86 ◽  
Author(s):  
P. Holstein

Healing of the stumps in 59 above-knee amputations was correlated with the local skin perfusion pressure (SPP) measured pre-operatively as the external pressure required to stop isotope washout using 131I-- or 125I--anti-pyrine mixed with histamine. Out of the 11 cases with an SPP below 30 mmHg no fewer than 9 (82 per cent) suffered wound complications. Out of the 48 cases with an SPP above 30 mmHg severe wound complications occurred in only 4 cases (8 per cent). The difference in wound complication rate is highly significant (P<0.01). It is concluded that the SPP can be used to predict ischaemic wound complications in above-knee amputations as has previously been shown to be the case in below-knee amputations.

1983 ◽  
Vol 7 (2) ◽  
pp. 61-62 ◽  
Author(s):  
H. C. Thyregod ◽  
P. Holstein ◽  
J. Steen Jensen

The healing in 20 through-knee amputations was compared with preoperatively measured skin perfusion pressure, determined as the minimal external pressure required to stop the washout of isotopes injected intradermally 10 cm distal to the knee joint. Out of 18 amputations with a skin perfusion pressure of above 20 mmHg only 2 failed to heal, whereas 2 out of 4 cases with skin perfusion pressure below 20 mmHg failed to heal. It is concluded that the through-knee amputation must be considered in cases where the circulation is borderline for healing in below-knee amputation.


1984 ◽  
Vol 8 (1) ◽  
pp. 39-42 ◽  
Author(s):  
J. Ovesen ◽  
M. Støckel

During a period of 14 months 60 amputations, 41 below-knee and 19 above-knee, were performed on 54 patients with gangrene of the lower limb. Wound healing was evaluated in 59 amputations. A newly introduced standardized photoelectric technique for measurement of the local skin perfusion pressure (SPP) was used preoperatively, the result of which served as a guide to the selection of the proper amputation level. An overall healing rate of 90 per cent was found. Sixty-eight per cent of the amputations were performed below-knee. The healing rates for individual SPP levels were identical to those obtained with the isotope washout technique. The standardized photoelectric technique is simple and rapid and gives only negligible discomfort to the patient allowing repeated measurements at different levels on the leg.


2021 ◽  
pp. 112972982199398
Author(s):  
Miju Bae ◽  
Sung Woon Chung ◽  
Chung Won Lee ◽  
Up Huh ◽  
Moran Jin ◽  
...  

Background: Access-related hand ischemia (ARHI) is a major complication of arteriovenous fistula (AVF). This study aimed to assess the predictive efficacy of skin perfusion pressure (SPP) measurement for ARHI by examining the relationship between SPP and ARHI development and progression after AVF surgery. Methods: Twenty-five patients (16 men and 9 women) who underwent AVF surgery based on the brachial artery between January 2018 and December 2018 were included. The pre- and postoperative SPP values were measured on the day of surgery. ARHI occurrence and severity were measured within 3 days and at 6 months after surgery. Receiver operating characteristic curve analysis was used to evaluate the prediction model of ARHI, and the cutoff points for the calculated coefficients were determined. Results: There was a significant correlation between the occurrence of immediate ARHI and the SPP gradient ( p = 0.024). An SPP gradient value >50 mmHg had sensitivity and specificity values of 53.85% and 91.67%, respectively, in predicting the occurrence of immediate ARHI. A postoperative SPP <48 mmHg was significantly correlated with the occurrence of 6-month ARHI ( p = 0.005), with sensitivity and specificity values of 71.43% and 83.33%, respectively. Conclusion: The SPP gradient and postoperative SPP values may be effective clinical predictors of ARHI occurring immediately and 6 months after surgery, respectively, with high specificity. These findings could allow clinicians to diagnose and begin early interventions to help prevent ischemic tissue damage in hemodialysis patients following AVF surgery.


2008 ◽  
Vol 37 (11) ◽  
pp. 431-438 ◽  
Author(s):  
Masaru Shimazaki ◽  
Takayuki Matsuki ◽  
Kazuaki Yamauchi ◽  
Michihiro Iwata ◽  
Hiroshi Takahashi ◽  
...  

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