Noninvasive determination of healing of major lower extremity amputation: The continued role of clinical judgment

摘要: Various tests are used preoperatively to differentiate patients who require an above-knee amputation (AKA) from those whose vascular supply is adequate heal a below-knee procedure (BKA). This 15-month study of 109 amputations compared four these methods: segmental Doppler systolic pressure measurements, transcutaneous oxygen measurement (tcPO2), fluorescein angiography, and skin thermometry. There were 66 BKAs (85% healed primarily) 43 AKAs (93% primarily). The actual level was determined by the operating surgeon without consideration preoperative test results, incidence healing then related parameters. average temperature at site higher (93.7 degrees F) in group that primarily with required operative stump revision (89.9 (p less than 0.001). mean midcalf tcPO2 also BKA (PO2 = 36.6 mm Hg) failed 16.4 Qualitative fluorescence successful differentiating success failure. Of 63 predicted would heal, eight (13%). pressures thigh, popliteal, midcalf, or ankle unreliable predicting BKA. Formulation indexes relating absolute brachial did not improve value this examination. From review it concluded obtained proposed most reliable prognostic noninvasive examinations.(ABSTRACT TRUNCATED AT 250 WORDS)