Skin perfusion pressure as a predictor of ischemic wound healing potential (Review)

Pan, Xuanliang; Chen, Guoxian; Wu, Pan; Han, Chunmao; Ho, Jon Kee

doi:10.3892/br.2018.1064

Cited by 11 publications

(12 citation statements)

References 44 publications

(60 reference statements)

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“…Such would indicate that SPP is an invaluable indicator of wound closure, irrespective of age or sex of the patient. Our results support similar trend findings on the utility and predictive potential of using SPP such as those reported in the meta-analysis conducted by Pan et al 14 …”

Section: Discussionsupporting

confidence: 93%

Skin Perfusion Pressure and Wound Closure Time in Lower Extremity Wounds

Suzuki

Birnbaum

Lockhart

2017

Journal of the American College of Clinical Wound Specialists

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IntroductionPeripheral Arterial Disease (PAD) affects approximately 8 million patients in the United States. We investigate the relationship of Skin Perfusion Pressure (SPP) and wound closure time in lower extremity wounds.MethodsWe conducted a retrospective study of 1125 lower extremity wounds in 998 patients between June 2006 and October 2014 in our wound clinic. We analyzed the relationship between SPPand wound closure time. SPP was measured using a Laser Doppler instrument.ResultsPatients with SPP values over 30 mmHg had shorter wound closure times, while patients with SPP values below 30 mmHg had a significantly longer wound closure time. Diabetic patients took longer to achieve wound closure compared to non-diabetics. No significant relationship was observed between SPP and wound closure time in relation to age or gender.ConclusionSPP is a useful tool in estimating time to wound closure and assessing the necessity of vascular interventions in lower extremity wounds.

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Section: Discussionsupporting

confidence: 93%

Skin Perfusion Pressure and Wound Closure Time in Lower Extremity Wounds

Suzuki

Birnbaum

Lockhart

2017

Journal of the American College of Clinical Wound Specialists

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“…Among them, laser Doppler is fast, effective, and easy to operate and is the most widely used method of measuring SPP. 54 In a study by Yamamoto et al, the authors have found that an increase in SPP of 20 mm Hg after bypass surgery was associated with better limb prognosis. 55 Novel noninvasive techniques include the oxygen-to-see method, which is an optical measuring technique that combines white light spectrometry and laser Doppler flowmetry, mapping oxygen saturation, relative hemoglobin, and blood flow in target tissues.…”

Section: Risk Stratification Models and Time To Heal Predictors Aftermentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

Predictors of Wound Healing Following Revascularization for Chronic Limb-Threatening Ischemia

Antonopoulos

Lazaris

Venermo

et al. 2019

Vasc Endovascular Surg

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Objectives: After surgical or endovascular revascularization, some ischemic lesions will not heal, while some others will heal at a variable period of time from the intervention, indicating a multifactorial interaction between local and systematic “wound healing–promoting” factors. Our objective was to identify predictors of wound healing following revascularization for chronic limb-threatening ischemia (CLTI). Methods: A literature review was performed to identify published research concerning clinical, biochemical, and noninvasive methods as predictors of wound healing time and wound-free period after surgical and endovascular revascularization for CLTI. Results: Our review indicated that potential predictors included local wound factors, wound depth, patient’s comorbidities, medications, smoking and alcohol abuse, poor vessel runoff, and direct versus indirect revascularization. Among the clinical biomarkers, platelet-derived growth factor, transforming growth factor β, basic fibroblast growth factor, tumor necrosis factor α, interleukin (IL) 1, and IL-6 have been proposed as potential predictors. Furthermore, the potential of noninvasive microcirculation assessment to predict proper wound healing has been the topic of extensive investigation. Among the novel methods, transcutaneous measurement of oxygen partial pressure, skin perfusion pressure, oxygen-to-see method, indocyanine green fluorescence imaging, and multispectral optoacoustic tomography have shown promising results. Conclusions: The risk factor profile of an ischemic lesion in the lower extremities with a delayed/failed healing response, following a successful revascularization, is not fully clarified. Although many predictors have been assessed so far, further research needs to be done to identify the optimal clinical and biochemical indices and the noninvasive technique assessing the microcirculation that is associated with complete wound healing.

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“…In this way, SPP measurements calculate the capillary opening pressure and provide an indirect estimation of the microcirculatory flow status within the artery at skin level[ 34 ]. SPP is advantageous in that it is not altered by vascular calcifications[ 35 ]. Notably, SPP values > 30 mmHg after successful endovascular treatment with balloon angioplasty and/or stenting have been correlated with improved wound healing in a retrospective study of 113 consecutive CLI patients, with a sensitivity and a specificity of 81.4% and 69.2%, respectively[ 34 ].…”

Section: Laser Doppler Skin Perfusion Pressure Measurements and Transcutaneous Oxygen Monitoringmentioning

confidence: 99%

“…Similarly, in patients exhibiting abnormal involuntary movements, reliable measurements will also not be feasible[ 48 ]. Other factors such as site selection, electrode equilibration, patient age, patient positioning, patient status before examination, pain, smoking and caffeine consumption, skin temperature changes, sympathetic tone, tissue edema, hyperkeratosis, cellulitis, and local skin integrity[ 35 , 39 ] may affect the accuracy of measurements, hence decreasing overall reliability. In addition, bony prominences, larger veins, or varicose veins should be avoided during cuff placement for SPP measurements, since they may produce artifacts[ 48 ].…”

Section: Laser Doppler Skin Perfusion Pressure Measurements and Transcutaneous Oxygen Monitoringmentioning

confidence: 99%

Quantifying tissue perfusion after peripheral endovascular procedures: Novel tissue perfusion endpoints to improve outcomes

Arkoudis¹,

Κατσάνος²,

Inchingolo³

et al. 2021

WJC

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Peripheral artery disease (PAD) is a flow-limiting condition caused by narrowing of the peripheral arteries typically due to atherosclerosis. It affects almost 200 million people globally with patients either being asymptomatic or presenting with claudication or critical or acute limb ischemia. PAD-affected patients display increased mortality rates, rendering their management critical. Endovascular interventions have proven crucial in PAD treatment and decreasing mortality and have significantly increased over the past years. However, for the functional assessment of the outcomes of revascularization procedures for the treatment of PAD, the same tests that have been used over the past decades are still being employed. Those only allow an indirect evaluation, while an objective quantification of limb perfusion is not feasible. Standard intraarterial angiography only demonstrates post-intervention vessel patency, hence is unable to accurately estimate actual limb perfusion and is incapable of quantifying treatment outcome. Therefore, there is a significant necessity for real-time objectively measurable procedural outcomes of limb perfusion that will allow vascular experts to intraoperatively quantify and assess outcomes, thus optimizing treatment, obviating misinterpretation, and providing significantly improved clinical results. The purpose of this review is to familiarize readers with the currently available perfusion-assessment methods and to evaluate possible prospects.

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Skin perfusion pressure as a predictor of ischemic wound healing potential (Review)

Cited by 11 publications

References 44 publications

Skin Perfusion Pressure and Wound Closure Time in Lower Extremity Wounds

Skin Perfusion Pressure and Wound Closure Time in Lower Extremity Wounds

Predictors of Wound Healing Following Revascularization for Chronic Limb-Threatening Ischemia

Quantifying tissue perfusion after peripheral endovascular procedures: Novel tissue perfusion endpoints to improve outcomes

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