Selection of amputation level in ischemia: Skin blood flow and perfusion pressure equally predictive

Jørgensen, Hans R. I.; Pedersen, Niels Wisbech; Oxhøj, H; Damholt, Villiam

doi:10.3109/17453679008993069

Cited by 10 publications

(4 citation statements)

References 12 publications

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“…It can detect the movement of red blood cells by slowly decreasing the inflation-cuff pressure at the site of measurement. SPP has proven to be beneficial for assessing the ischemic severity of lower limb [6, 7], selecting of suitable degree of amputation [8, 9], and useful for judgment of likelihood that ischemic foot ulcers will recover [10, 11]. SPP measurements have advantages for predicting wound healing at the amputation edge in chronic critical limb ischemia with a cutoff value of <30 mm Hg [12].…”

Section: Introductionmentioning

confidence: 99%

Skin Perfusion Pressure Is a Prognostic Factor in Hemodialysis Patients

Saito¹,

Ishigaki²,

Yamamoto

et al. 2012

International Journal of Nephrology

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Peripheral arterial disease (PAD) is common in hemodialysis patients and predicts a poor prognosis. We conducted a prospective cohort study to identify risk factors for PAD including skin perfusion pressure (SPP) in hemodialysis patients. The cohort included 373 hemodialysis patients among 548 patients who received hemodialysis at Oyokyo Kidney Research Institute, Hirosaki, Japan from August 2008 to December 2010. The endpoints were lower limb survival (peripheral angioplasty or amputation events) and overall survival of 2 years. Our results showed that <70 mmHg SPP was a poor prognosis for the lower limb survival and overall survival. We also identified age, history of cardiovascular disease, presence of diabetes mellitus, smoking history, and SPP < 70 mmHg as independent risk factors for lower limb survival and overall survival. Then, we constructed risk criteria using the significantly independent risk factors. We can clearly stratify lower limb survival and overall survival of the hemodialysis patients into 3 groups. Although the observation period is short, we conclude that SPP value has the potential to be a risk factor that predicts both lower limb survival and the prognosis of hemodialysis patients.

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Section: Introductionmentioning

confidence: 99%

Skin Perfusion Pressure Is a Prognostic Factor in Hemodialysis Patients

Saito¹,

Ishigaki²,

Yamamoto

et al. 2012

International Journal of Nephrology

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show abstract

“…SPP can detect the movement of red blood cells by slowly decreasing the inflation cuff pressure at the site of measurement. SPP has proven to be beneficial for assessing lower limb ischemic severity, 4,5 selecting the most suitable degree of amputation, 6,7 and judging the likelihood that an ischemic foot ulcer will resolve. 8,9 SPP measurements are advantageous for predicting wound healing at the amputation edge in critical limb ischemia (CLI) patients, with a cutoff value of ,30 mmHg.…”

mentioning

confidence: 99%

Predictive Value of Skin Perfusion Pressure After Endovascular Therapy for Wound Healing in Critical Limb Ischemia

Utsunomiya¹,

Nakamura²,

Nagashima³

et al. 2014

Journal of Endovascular Therapy

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“…Recently, among various noninvasive diagnostic methods, measurement of the SPP has proven useful as the assessment of severity of ischemia, [1][2][3] selecting the proper level of amputation, [4][5][6][7] and judging the likelihood that ischemic foot ulcers will heal. [8][9][10] It is easily performed at the bedside and requires only 15 min.…”

mentioning

confidence: 99%

The effect of different positions on lower limbs skin perfusion pressure

Kawasaki

Uemura²,

Matsuo

et al. 2013

Indian J Plast Surg

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We have encountered situations of patients with critical limb ischemia accompanied by pain at rest and necrosis, who hang their legs down from the bed during sleep. This lower limb position is known to be a natural position, which reduces pain in the lower extremity induced by ischemia. However, the effect of this position on blood flow of the lower extremity is poorly understood. We studied whether measurements of skin perfusion pressure (SPP) changes by leg position and the difference between healthy adults and patients with critical limb ischemia. The subjects of this study were 10 healthy adults and 11 patients with critical limb ischemia. Patients with critical limb ischemia, including both dorsum of foot and plantar of foot, having SPP of lower limbs of less than 40 mmHg (supine position) were the object of this study. SPP was measured on four positions (supine position, lower limbs elevation position, sitting position, and reclining bed elevation of 20° position). In sitting position, both the number of healthy adults and critical patients show significant increases in SPP compared with the other three positions. These results suggest that sitting position is effective to keep good blood stream of lower limbs not only in healthy adults but also in patients with critical limb ischemia. However, an appropriate leg position should not have lower limbs hang downwards for long periods time because edema is caused by the fall in venous return in lower limbs, and the wound healing is prolonged.Our clinical research could be more useful in the future, particularly in developing countries, for surgeons managing wounds in leg and foot and preserving ischemic limbs.

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Selection of amputation level in ischemia: Skin blood flow and perfusion pressure equally predictive

Cited by 10 publications

References 12 publications

Skin Perfusion Pressure Is a Prognostic Factor in Hemodialysis Patients

Skin Perfusion Pressure Is a Prognostic Factor in Hemodialysis Patients

Predictive Value of Skin Perfusion Pressure After Endovascular Therapy for Wound Healing in Critical Limb Ischemia

The effect of different positions on lower limbs skin perfusion pressure

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