Clinical reliability and utility of skin perfusion pressure measurement in ischemic limbs—Comparison with other noninvasive diagnostic methods

Yamada, Tetsuya; Ohta, Takashi; Ishibashi, Hiroyuki; Sugimoto, Ikuo; Iwata, Hirohide; Takahashi, Masayuki; Kawanishi, Jun

doi:10.1016/j.jvs.2007.10.045

Cited by 171 publications

(157 citation statements)

References 25 publications

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“…1, C and D). The pair-matched SPP recorded in the intact pig skin tightly matched the values seen in healing wounds (67). Fullthickness biopsy wounds were placed on the ischemic tissue or adjacent nonischemic tissue as shown in Fig.…”

Section: Resultsmentioning

confidence: 71%

“…Among a number of noninvasive diagnostic methods, measurement of the SPP has proven utility for assessing the severity of ischemia at the wound site. Measurement of SPP represents an objective approach to assess the severity of peripheral arterial disease or for predicting wound healing (53,67). SPP measurements from the above-described bipedicle flaps and comparison with SPP measured from the adjacent intact skin demonstrated that the bipedicle flaps had an SPP consistent with the SPP of chronic nonhealing wounds (Fig.…”

Section: Resultsmentioning

confidence: 94%

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Characterization of a preclinical model of chronic ischemic wound

Roy

Biswas

Khanna

et al. 2009

Physiological Genomics

111

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Chronic ischemic wounds presenting at wound clinics are heterogeneous with respect to etiology, age of the wound, and other factors complicating wound healing. In addition, there are ethical challenges associated with collecting repeated biopsies from a patient to develop an understanding of the temporal dynamics of the mechanisms underlying chronic wounds. The need for a preclinical model of ischemic wound is therefore compelling. The porcine model is widely accepted as an excellent preclinical model for human wounds. A full-thickness bipedicle flap approach was adopted to cause skin ischemia. Closure of excisional wounds placed on ischemic tissue was severely impaired resulting in chronic wounds. Histologically, ischemic wounds suffered from impaired re-epithelialization, delayed macrophage recruitment and poorer endothelial cell abundance and organization. Compared with the pair-matched nonischemic wound, unique aspects of the ischemic wound biology were examined on days 3, 7, 14, and 28 by systematic screening of the wound tissue transcriptome using high-density porcine GeneChips. Ischemia markedly potentiated the expression of arginase-1, a cytosolic enzyme that metabolizes the precursor of nitric oxide l-arginine. Ischemia also induced the SOD2 in the wound tissue perhaps as survival response of the challenged tissue. Human chronic wounds also demonstrated elevated expression of SOD2 and arginase-1. This study provides a thorough database that may serve as a valuable reference tool to develop novel hypotheses aiming to elucidate the biology of ischemic chronic wounds in a preclinical setting.

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Section: Resultsmentioning

confidence: 71%

Section: Resultsmentioning

confidence: 94%

Characterization of a preclinical model of chronic ischemic wound

Roy

Biswas

Khanna

et al. 2009

Physiological Genomics

111

View full text Add to dashboard Cite

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“…The postoperative SPP values in group N were better than those in group U but less than those in group H. Compared with group H, group N featured more patients with chronic kidney disease and group U had even more. Additionally, groups N and U included more patients with diabetes than group H; therefore, the patients in groups N and U could have had more advanced distal lesions than did the patients in group H. [12][13][14] Previous studies have suggested a value of 30 mmHg 1,2,6) or 40 mmHg 4,5) to be the critical SPP threshold necessary for wound healing. In the present study, 50% of the limbs had a mean postoperative SPP value of <30 mmHg in group U, consistent with the results of previous reports.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,[4][5][6] We started SPP measurements following the establishment of a vascular laboratory at our institution in August 2008. Although the number of examinations of SPP is still small in our institution at present, we deemed it useful to have an initial evaluation of its effectiveness by retrospectively assessing the changes in SPP values obtained between the pre-and postoperative periods 8,9) and the relationship between the SPP values and ulcer healing, in order to assess the utility of SPP measurement in evaluating the outcome of arterial reconstructions in patients with CLI caused by arteriosclerosis obliterans (ASO).…”

Section: Skin Perfusion Pressure Measurement To Assess Improvement Inmentioning

confidence: 99%

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Skin Perfusion Pressure Measurement to Assess Improvement in Peripheral Circulation after Arterial Reconstruction for Critical Limb Ischemia

Watanabe

Onozuka

Obitsu

et al. 2011

Annals of Vascular Diseases

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Aim:To assess the utility of skin perfusion pressure (SPP) measurement in evaluating the outcome of vascular constructions for critical limb ischemia (CLI) patients. Methods: We retrospectively studied 19 lower limbs in 18 patients who underwent arterial reconstruction for CLI from whom SPP measurements had been obtained pre-and postoperatively between 2008 and 2010. Six limbs whose ulcers had healed postoperatively were classified into group H, 7 limbs whose ulcers had not healed into group U, and 6 limbs without ulcers into group N. SPP values were compared among these groups. Results: The preoperative SPP values in all groups were <30 mmHg, without significant differences among the groups. The SPP values in groups H and N significantly improved after operation, and those in group U were significantly lower than those in the other groups. Conclusions: SPP measurement before and after arterial reconstruction is useful to assess improvement in tissue circulation and to predict the likelihood of wound healing. An SPP value ≥30 mmHg was considered necessary for wound healing, supporting the findings of the few reports in the literature on the usefulness of SPP for assessing vascular reconstruction effects on ulcer wound healing.

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Vascular Laboratory Evaluation of Peripheral Artery Disease

Rooke

2017

Peripheral Artery Disease

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Clinical reliability and utility of skin perfusion pressure measurement in ischemic limbs—Comparison with other noninvasive diagnostic methods

Abstract: Our results suggest that measurement of SPP is an objective method for assessing the severity of peripheral arterial disease or for predicting wound healing.

Cited by 171 publications

References 25 publications

Characterization of a preclinical model of chronic ischemic wound

Characterization of a preclinical model of chronic ischemic wound

Skin Perfusion Pressure Measurement to Assess Improvement in Peripheral Circulation after Arterial Reconstruction for Critical Limb Ischemia

Vascular Laboratory Evaluation of Peripheral Artery Disease

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