scholarly journals Measurement of skin perfusion pressure by photoelectric technique– an aid to amputation level selection in arteriosclerotic disease

1984 ◽  
Vol 8 (1) ◽  
pp. 39-42 ◽  
Author(s):  
J. Ovesen ◽  
M. Støckel
Keyword(s):  
Healing Rate ◽  
Perfusion Pressure ◽  
Repeated Measurements ◽  
Local Skin ◽  
Skin Perfusion ◽  
Amputation Level ◽  
Skin Perfusion Pressure ◽  
Photoelectric Technique ◽  
Different Levels ◽  
Selection Of

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.

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
Keyword(s):  
Complication Rate ◽  
Perfusion Pressure ◽  
Wound Complication ◽  
External Pressure ◽  
Wound Complications ◽  
Local Skin ◽  
Skin Perfusion ◽  
Skin Perfusion Pressure ◽  
The Difference

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.

Skin perfusion pressure for predicting access-related hand ischemia following arteriovenous fistula surgery based on the brachial artery

2021 ◽  
pp. 112972982199398
Author(s):  
Miju Bae ◽  
Sung Woon Chung ◽  
Chung Won Lee ◽  
Up Huh ◽  
Moran Jin ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Sensitivity And Specificity ◽  
Brachial Artery ◽  
Perfusion Pressure ◽  
Characteristic Curve ◽  
Major Complication ◽  
Clinical Predictors ◽  
Skin Perfusion ◽  
Hand Ischemia ◽  
Skin Perfusion Pressure

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.

scholarly journals Measurement of Skin Perfusion Pressure in Hemodialyzed Patients: Association with Toe/Brachial Index

2008 ◽  
Vol 37 (11) ◽  
pp. 431-438 ◽  
Author(s):  
Masaru Shimazaki ◽  
Takayuki Matsuki ◽  
Kazuaki Yamauchi ◽  
Michihiro Iwata ◽  
Hiroshi Takahashi ◽  
...  
Keyword(s):  
Perfusion Pressure ◽  
Skin Perfusion ◽  
Skin Perfusion Pressure ◽  
Toe Brachial Index

Low plantar skin perfusion pressure predicts long-term atherosclerotic vascular events and mortality in maintenance haemodialysis patients

2020 ◽  
Vol 312 ◽  
pp. 66-71
Author(s):  
Maki Hiratsuka ◽  
Katsushi Koyama ◽  
Hiroshi Takahashi ◽  
Takahisa Kasugai ◽  
Junichiro Hagita ◽  
...  
Keyword(s):  
Perfusion Pressure ◽  
Vascular Events ◽  
Skin Perfusion ◽  
Maintenance Haemodialysis ◽  
Skin Perfusion Pressure

Changes in Skin Perfusion Pressure After Endovascular Treatment for Chronic Limb-Threatening Ischemia

2020 ◽  
pp. 152660282096393
Author(s):  
Shigeo Ichihashi ◽  
Mitsuyoshi Takahara ◽  
Naoki Fujimura ◽  
Tsuyoshi Shibata ◽  
Miki Fujii ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Perfusion Pressure ◽  
Peroneal Artery ◽  
Prospective Multicenter Study ◽  
Skin Perfusion ◽  
Posterior Tibial ◽  
Tibial Arteries ◽  
Skin Perfusion Pressure ◽  
Indirect Revascularization ◽  
Preoperative Factors

Purpose To assess skin perfusion pressure (SPP) changes after endovascular treatment (EVT) of patients with chronic limb-threatening ischemia (CLTI) and to explore preoperative factors that affect SPP changes. Materials and Methods This prospective, multicenter study recruited 147 patients (mean age 74 years; 99 men) with ischemic wounds at 6 vascular centers in Japan between July 2017 and December 2018. Over half of the patients (92, 63%) were diabetic, and 76 (52%) required dialysis. Sixty-four patients (43%) had WIfI (wound, ischemia, foot infection) wound grades of 2 or 3; 59 (40%) had foot infections. SPP was measured before and 1, 2, 7, and 30 days after EVT to establish inline flow to the ischemic foot based on the angiosome concept when feasible. The anterior and posterior tibial arteries and the peroneal artery were revascularized in 66 (45%), 50 (34%), and 30 (21%) patients, respectively. Results Both the dorsal and plantar SPPs at 1 or 2 days post-EVT were significantly higher than those at baseline (p<0.001), and both SPPs increased further at 1 month compared with those at 1 (p=0.001) or 2 days (p=0.006) post-EVT. SPP increases occurred on the dorsal and plantar surfaces of the foot regardless of the vessel revascularized. The SPP increase at 1 month after EVT was significantly lower in patients with foot infections than that in those without foot infections (p=0.003). Age, sex, diabetes, dialysis, wound severity, and direct revascularization did not affect the pattern of SPP change. Conclusion The SPP increased continuously up to 1 month after EVT, though the increase was smaller in patients with wound infections. The SPP on the dorsal and plantar surfaces increased, regardless of the vessel revascularized, which could justify indirect revascularization when direct revascularization is technically challenging.

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