Healing of Ulcers on the Feet Correlated with Distal Blood Pressure Measurements in Occlusive Arterial Disease

Holstein, P.; Lassen, Niels A.

doi:10.3109/17453678008990906

Cited by 74 publications

(69 citation statements)

References 10 publications

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“…However, values of 40-50 mm Hg seem to be adequate if infection can be controlled. This is in agreement with our previous study of perYusion pressures on the heel as measured with the photoelectric technique (Holstein & Lassen 1980) and it is about 10-20 mm Hg more than that required for healing of a below-knee amputation. However, it must be emphasized that the elimination of tissue in major amputations is great, leading to better circulation of the remaining stump (Lassen & Holstein 1974, Holstein et al 197913, Holloway & Burgess 1978.…”

Section: Discussionsupporting

confidence: 81%

“…The ankle pressure is the most widely used parameter. Some authors have found the ankle pressure to be valuable (Carter 1973, Raines et al 1976, Verta et al 1976, Baker & Barnes 1977, Wagner & Buggs 1978, Holstein & Lassen 1980, Nicholas et al 1982, while other authors have found it less useful (Gibbons et al 1979, Mehta et al 1980, Bone & Pomajzl 1981. A gray zone of healing is poorly defined and failures are not infrequent at high pressures, either because of infection or because ankle pressures are estimated too high at medial sclerosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, the ankle pressure is still a valuable parameter because low values (< 50 mm Hg) indicate that the limb is seriously threatened and because it can be measured in nearly all cases. Healing of foot lesions in relation to digital pressures was studied by Carter (1973) and by Holstein & Lassen (1980). In Carter's series digital pressures in non-diabetics of above 30 mm Hg indicated a good healing prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…The systolic digital blood pressure (SDBP). According to previous investigations in this laboratory (Holstein & Lassen 1980) and to the appearance of the histogram (Figure l), the feet were classified into three groups ( Table 2) Hg, 13 out of 22 minor amputations healed -i.e.…”

Section: Healingmentioning

confidence: 99%

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The distal blood pressure predicts healing of amputations on the feet

Holstein

1984

Acta Orthopaedica Scandinavica

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The healing of digital and transmetatarsal forefoot amputations was compared with the systolic digital and ankle blood pressure, both measured with a strain-gauge, and with the skin perfusion pressure on the forefoot measured with the isotope washout technique. In 85 out of 134 legs (63 per cent) the amputation healed. The frequency of healing correlated statistically significantly with all three measures of distal blood pressures, the closest correlation being with the systolic digital blood pressure (SDBP). As measured in 110 cases the healing rates were: SDBP < 20 mm Hg: four out of 23; SDBP 20-29 mm Hg: 13 out of 22; SDBP 2 30 mm Hg: 51 out of 65. Ankle pressures and skin perfusion pressures were less useful. Invasive infection was present in 40 out of 102 diabetic legs and, next to ischaemia, was the major determinant of the healing results.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Healingmentioning

confidence: 99%

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The distal blood pressure predicts healing of amputations on the feet

Holstein

1984

Acta Orthopaedica Scandinavica

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“…Per Holstein (11,12), based on his 20 years of experience with this technique. The spontaneous healing of ulcers was shown to be predicted by this measurement, such that a TSBP <20 mmHg was associated with only a 29% healing rate compared with a healing rate of 92% for subjects with a TSBP >30 mmHg.…”

mentioning

confidence: 99%

Assessment of Peripheral Vascular Disease in Diabetes: Report and Recommendations of an International Workshop Sponsored by the American Heart Association and the American Diabetes Association

1993

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R ecognizing the considerable excess burden of both cerebrovascular disease and LEAD suffered by individuals with IDDM or NIDDM (1,2), a workshop was convened to 1) provide a current review of the knowledge pertaining to the prevalence, incidence, and risk factor associations of cerebrovascular disease and PVD in diabetes, and 2) review and make recommendations about the methodology for identifying and quantifying LEAD in both clinical and research settings.The workshop focused on the specific problems of measurement of PVD in diabetes and the need for a standard approach to ensure appropriate care and facilitate comparability of research findings across studies and over time. Recommendations for the measurement of LEAD in a primary-care setting and for epidemiological studies were developed, along with recommendations for more detailed assessment after referral to a vascular clinic. Specific recommendations for the assessment of cerebrovascular disease were not addressed.

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A New Concept of a Multidisciplinary Wound Healing Center and a National Expert Function of Wound Healing

Gottrup

Holstein²,

Jørgensen³

et al. 2001

Arch Surg

150

111

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Hypothesis: An independent, multidisciplinary wound healing center in an accepted national expert function of wound healing is the optimal way to improve prophylaxis and treatment of patients with problem wounds.Design: A clinical perspective analysis.Setting: An independent, multidisciplinary wound healing center focusing on all types of problem wounds, organized as a university hospital department, and integrated in an expert function in the national health care organization of Denmark.Patients and Methods: Patients with all types of problem wounds referred to and treated in the center during the first years of its existence provided a model for a new multidisciplinary structure for treatment of wound patients in the health care system.Results: During the first 3 years of the fully functioning wound healing center, a total of 23 802 patient consultations were performed in the outpatient clinic, and 1014 patients with problem wounds were hospitalized in the inpatient ward. The surgical concept of the center

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Healing of Ulcers on the Feet Correlated with Distal Blood Pressure Measurements in Occlusive Arterial Disease

Cited by 74 publications

References 10 publications

The distal blood pressure predicts healing of amputations on the feet

The distal blood pressure predicts healing of amputations on the feet

Assessment of Peripheral Vascular Disease in Diabetes: Report and Recommendations of an International Workshop Sponsored by the American Heart Association and the American Diabetes Association

A New Concept of a Multidisciplinary Wound Healing Center and a National Expert Function of Wound Healing

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