Assessment of tissue viability in relation to the selection of amputation level

Spence, V. A.; McCollum, P. T.; Walker, W. F.; Murdoch, George

doi:10.3109/03093648409145351

Cited by 12 publications

(2 citation statements)

References 30 publications

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“…In a later paper in 1984, they discussed three methods in use for amputation level assessment: partial oxygen pressure, skin blood flow, and infrared thermography. 21 One group, that compared thermography with Doppler flowmetry and clinical judgment of an experienced surgeon, did not support their findings. Their conclusion was that the experienced surgeon was the most reliable method and that other methods are only an adjunct to clinical assessment.…”

Section: Thermal Imaging Applied To Diabetic Diseasesmentioning

confidence: 92%

Thermal Imaging Today and Its Relevance to Diabetes

Ring

2010

J Diabetes Sci Technol

135

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From the historic and simple assessment of temperature by the clinical thermometer, modern infrared technology has opened up new perspectives, especially in the use of thermal imaging to map body surface temperature with a remote sensing camera. Since the 1960s, there is now a greater understanding of thermal physiology and the relationship between skin temperature and blood perfusion. Furthermore, the examination technique, and the advantages of computer-aided digital imaging has greatly improved the reliability of this technology in medicine. Studies in diabetology have shown the value of this new facility and its relevance to clinical assessment of peripheral perfusion and tissue viability.

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Section: Thermal Imaging Applied To Diabetic Diseasesmentioning

confidence: 92%

Thermal Imaging Today and Its Relevance to Diabetes

Ring

2010

J Diabetes Sci Technol

135

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“…Оценка оптимального уровня ампутации травмированной конечности в ряде случаев является исключительно сложной. В связи с этим разработаны соответствующие неинвазивные и инвазивные вспомогательные методы для помощи в выборе уровня ампутации [39].…”

Section: находит широкое применение лазерная допплеровская флоуметрия -Laser Do-pplerunclassified

Salvage or Amputation of a Limb? Evaluation Scales and Diagnostics of Soft Tissue Condition in the System of Treatment of Severe Limb Injuries With Massive Bone Loss

Grebenyuk¹

2021

СПНО (MPSE)

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Цель работы -анализ современной литературы, описывающей диагностические возможности оценки состояния мягких тканей у пациентов с тяжелыми повреждениями конечностей и использование балльных шкал при выборе оперативного лечения для сохранения конечности. Проблема спасения конечности связана с оценкой жизнеспособности тканей критически поврежденной конечности и состоит в правильном первоначальном решении, стоит ли сохранять («to salvage») конечность. С учетом типа и тяжести травматического повреждения используются различные методики оценки состояния тканей: лазерная допплеровская флоуметрия; полярография кожи или микрозонд, измеряющий напряжение кислорода в мышцах; ультрасонография и допплерография с вживлением датчика в мягкие ткани; импедансометрия; акустовелосиметрия кожи; двухфазная сцинтиграфия, проводимая интраоперационно, для уточнения степени жизнеспособности тканей и уровня ампутации. Интегративный подход основан на использовании различных оценочных шкал: 1) MESS (Mangled Extremity Severity Score) и 2) индекса спасения конечности -LSI (Limb Salvage Index). Эти балльные шкалы количественно оценивают степень повреждения костных структур, нервов, периферических сосудов и других мягких тканей. Они высокочувствительны и специфичны, но имеют все же относительное значение. В проблеме сохранения или ампутации конечности важен интегративный подход не только в дооперационном периоде, но и в процессе лечения для прогнозирования ампутации и возможных осложнений. Ключевые слова: тяжелые повреждения, сохранение конечности, ампутация, диагностика жизнеспособности тканей, оценочные шкалы поврежденной конечности.

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Oxygen inhalation induced changes in the skin as measured by transcutaneous oxymetry

McCollum

Spence

Walker

1986

Journal of British Surgery

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Transcutaneous oxygen (PtcO2) measurements were made on 46 patients with severe ischaemia of the lower limbs and on 17 age-matched controls. Values breathing air, 100 per cent oxygen and the rate of change of PtcO2 breathing oxygen were recorded. Of 29 below knee amputations there were 4 failures; 16 had PtcO2 values less than 35 mmHg, but 12 of the 16 healed. When the rate of change of PtcO2 during oxygen inhalation was greater than 9 mm Hg/min all below knee amputations healed; all 4 failures were found to have values less than 9 mm Hg/min while only one patient with a value of less than 9 mm Hg/min healed a below knee amputation. This study shows that low PtcO2 values are a poor indication of healing potential. A more reliable index of skin viability is provided by the dynamic measurement of PtcO2 changes during oxygen inhalation. The addition of an oxygen inhalation test, when making PtcO2 measurements, greatly enhances the applicability of the technique in the assessment of the oxygen supply to the skin.

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Assessment of tissue viability in relation to the selection of amputation level

Cited by 12 publications

References 30 publications

Thermal Imaging Today and Its Relevance to Diabetes

Thermal Imaging Today and Its Relevance to Diabetes

Salvage or Amputation of a Limb? Evaluation Scales and Diagnostics of Soft Tissue Condition in the System of Treatment of Severe Limb Injuries With Massive Bone Loss

Oxygen inhalation induced changes in the skin as measured by transcutaneous oxymetry

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