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

Watanabe, Yoshinori; Onozuka, Atsuko; Obitsu, Yukio; Komai, Hiroyoshi; Koizumi, Noriko; Saiki, Naozumi; Shigematsu, Hiroshi

doi:10.3400/avd.oa.11.00022

Cited by 17 publications

(17 citation statements)

References 15 publications

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“…For instance, Watanabe et al (33) retrospectively examined 19 lower limbs in 18 patients who had undergone arterial reconstruction for CLI, and identified that an SPP ≥30 mmHg was a requisite for wound healing. Also noteworthy is a previous prospective, single center comparative study, in which SPPs in 100 patients with chronic extremity wounds were examined, which also suggested that SPP with a value ≥30 mmHg was a useful positive independent predictor of wound healing potential (8).…”

Section: Predictive Value Of Spp In Wound Healing During Limb Ischemiamentioning

confidence: 99%

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

Pan

Chen

et al. 2018

biom rep

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Abstract. Skin perfusion pressure (SPP) is the blood pressure that is the requisite for the restoration of microcirculatory or capillary flow following controlled occlusion and subsequent flow return. The purpose of the current review was to evaluate the value of SPP for the prediction of wound healing in patients with limb ischemia. Articles published up to January 31, 2017 were searched in the PubMed database and Chinese database CNKI, using the keywords of 'skin perfusion pressure', 'limb ischemia' and 'wound healing'. Articles were obtained and reviewed to analyze the predictive value of SPP with regard to the healing potential of ischemia wounds on limbs. Three different types of techniques are currently used for the measurement of SPP, namely radioisotope clearance, photoplethysmography and laser Doppler, with laser Doppler as the most widely applied technique, due to its noninvasiveness and ease of operability. SPP may effectively assess wound healing potential in ischemic limbs with high sensitivity and specificity; however, its optimum cut-off point remains uncertain. Compared with other noninvasive microcirculatory assessment tools including ankle-brachial index, toe blood pressure and transcutaneous oxygen pressure, SPP has its advantages including that it is not affected by vascular calcification, anatomical structure or patient condition. In conclusion, SPP may be used as an index to accurately predict wound healing in patients with limb ischemia. However, it is difficult to determine the optimum cut-off of SPP due to the limitations of current data. Further study is necessary to confirm the optimum cut-off value of SPP in predicting wound healing potential.

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Section: Predictive Value Of Spp In Wound Healing During Limb Ischemiamentioning

confidence: 99%

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

Pan

Chen

et al. 2018

biom rep

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“…The use of SPP measurement in AVAIS treatment has recently been reported . The usefulness of SPP has been established in the assessment of critical ischaemia, and significant correlations have been found with peripheral blood pressure and transcutaneous oxygen pressure. SPP is a reliable monitoring tool for predicting wound healing: wounds and ulcers with SPP < 30 mm Hg do not heal, and SPP > 40 mm Hg indicates the ability of a wound to heal.…”

Section: Discussionmentioning

confidence: 99%

Utility of perioperative skin perfusion pressure measurement for treatment of ulcers caused by arteriovenous access ischaemic steal

Atomura

Aihara

Ōmori

et al. 2018

International Wound Journal

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Arteriovenous access ischaemic steal is a serious complication following arteriovenous fistula (AVF) construction. The aim of treatment is to improve distal circulation without impairing the function of the fistula. Therefore, any repair should be performed with intraoperative monitoring. We report 2 cases of this disorder treated using perioperative measurement of skin perfusion pressure (SPP) for preoperative surgical planning and intraoperative guidance. A 73-year-old woman with a left cubital AVF developed gangrene of the tip of the left little finger. Arteriovenous access ischaemic steal was suspected. The SPP of the little finger was 18 mm Hg, which increased to 65 mm Hg after manual occlusion of the fistula. A 58-year-old woman with a left antebrachial AVF had gangrene of the tip of the left middle finger. The SPP was 19 mm Hg, and steal syndrome was suspected based on angiography and the SPP with manual occlusion of the fistula. In both cases, serial plication of the fistula was performed based on intraoperative perfusion pressure monitoring, leading to the successful resolution of the ischaemic steal syndrome. In both cases, haemodialysis could be continued through the repaired fistula.

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“…However, even though the SPP became detectable, the states of the feet with ulcer in which SPP could not reach 30 mmHg in both aspects were worse as shown in previous reports on traditional SPP measurement. 12,13) On the other hand, the foot in which the SPP became detectable as larger than 30 mmHg did not have ulcer. Additionally, there were no feet that developed ulcer in which the SPP values exceeded 50 mmHg in both aspects of the feet after heating.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Characteristics and Detectability of Skin Perfusion Pressure Measured Using a Thermostatic Heating Probe

Watanabe

Hara

Kojima

et al. 2013

Annals of Vascular Diseases

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Objectives: To assess the characteristics of skin perfusion pressure (SPP) measured using a thermostatic heating probe and whether a thermostatic heating probe improves SPP detection. Methods:We studied 8 feet of healthy young subjects and 31 feet of elderly patients suspected to have severe limb ischemia. We measured SPP at the dorsum and plantar aspects of each foot using a plain laser Doppler probe and a thermostatic heating probe heated at 44°C. Results were expressed as median. Comparisons were analyzed using a non-parametric test. Results: In the healthy subjects, the SPP values at both the dorsum and the plantar aspect were not significantly different after heating. The thermostatic heating probe did not improve the SPP detection rates. In the patients with ischemic limb, the SPP values at both the dorsum and the plantar aspect significantly increased after heating (p <0.001 for both). The SPP detection rate at the dorsum remained at 96.8%; however, it was improved from 87.1% to 100% at the plantar aspect after heating. Conclusion: The thermostatic heating probe was shown to be useful for improving the detectability of SPP in the ischemic limbs. An SPP increase after heating may be considered as a parameter of limb ischemia.

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

Cited by 17 publications

References 15 publications

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

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

Utility of perioperative skin perfusion pressure measurement for treatment of ulcers caused by arteriovenous access ischaemic steal

Assessment of the Characteristics and Detectability of Skin Perfusion Pressure Measured Using a Thermostatic Heating Probe

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