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ORIGINAL ARTICLE
Italian Journal of Vascular and Endovascular Surgery 2017 September;24(3):83-8
DOI: 10.23736/S1824-4777.17.01296-7
Copyright © 2017 EDIZIONI MINERVA MEDICA
lingua: Inglese
Skin perfusion pressure and healing after below-the-knee amputation
Kate SMIDT 1 ✉, Jan ABRAHAMSEN 2, Niels H. KRARUP 1, Thomas JAKOBSEN 3
1 Department of Orthopedic Surgery, Regional Hospital, Viborg, Denmark; 2 Department of Clinical Physiology, Regional Hospital, Viborg, Denmark; 3 Department of Orthopedic Surgery, Aalborg University Hospital, Aalborg, Denmark
BACKGROUND: The purpose of this study was to investigate if there is a correlation between preoperative measurement of skin perfusion pressure (SPP) and healing after below-the-knee amputation (BTKA) in order to optimize our treatment of the elderly, often fragile patients who represents the majority of amputees in Denmark.
METHODS: We conducted a retrospective study of 104 consecutive patients, who all had a BTKA at a medium-sized Danish hospital during a period of five years. Sixty-seven of these patients had a preoperative SPP measurement. They were divided into two groups according to their SPP. One group with SPP of or below 40 mmHg, and one group with a SPP above 40 mmHg. Subsequent we conducted a χ2 test to compare the two groups.
RESULTS: Our primary outcome was an above-the-knee amputation (ATKA) within 90 days after the first amputation, while secondary outcomes were wound debridement (WD) in the operating room or death within 90 days. We found a statistical difference between the two groups of SPP compared to ATKA, but no statistical difference compared to WD or death.
CONCLUSIONS: There seem to be a correlation between SPP and healing after BTKA, however 13% of our patients with a SPP above 40 mmHg needed an ATKA within 90 days of their primary BTKA. To clarify if a SPP of 40 mmHg is enough to predict healing after amputation it is necessary to conduct a prospective study. It is furthermore necessary to determine which factors other than skin perfusion play a part in healing after an amputation.
KEY WORDS: Amputation - Lower extremity - Skin ulcer