John J. Castronuovo, MD, Habtu M. Adera, MD, Janice M

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Presentation transcript:

Skin perfusion pressure measurement is valuable in the diagnosis of critical limb ischemia John J. Castronuovo, MD, Habtu M. Adera, MD, Janice M. Smiell, MD, Ray M. Price, PhD Journal of Vascular Surgery Volume 26, Issue 4, Pages 629-637 (October 1997) DOI: 10.1016/S0741-5214(97)70062-4 Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Display of skin perfusion pressure monitor showing bar chart registering degree of skin perfusion for each pressure interval applied by blood pressure cuff encircling limb with critical ischemia and SPP of 5 mm Hg. Journal of Vascular Surgery 1997 26, 629-637DOI: (10.1016/S0741-5214(97)70062-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Same display as in Fig. 1 for a limb without critical ischemia with an SPP of 50 mm Hg. Journal of Vascular Surgery 1997 26, 629-637DOI: (10.1016/S0741-5214(97)70062-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 SPP values for all limbs. Group I patients (n = 32) required vascular reconstruction or major amputation in the opinion of vascular attending surgeon. Group II patients (n = 29) were not thought to require vascular reconstruction to heal and were managed with local debridement, minor amputation, or both. All foot lesions and amputation wounds in group I healed. Journal of Vascular Surgery 1997 26, 629-637DOI: (10.1016/S0741-5214(97)70062-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 SPP values for diabetic and nondiabetic patients in group II healed versus healing failure. There was no difference in the prevalence of diabetes in limbs that healed and limbs with healing failure. Journal of Vascular Surgery 1997 26, 629-637DOI: (10.1016/S0741-5214(97)70062-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 ABI values for all limbs. There was no significant difference in mean ABI between group I and group II. Journal of Vascular Surgery 1997 26, 629-637DOI: (10.1016/S0741-5214(97)70062-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 ABI values for group II patients. There was no significant difference in mean ABI between healed and healing failure patients or between patients with and without diabetes, although the number of nondiabetic patients is probably too small in group II to draw a meaningful conclusion. Journal of Vascular Surgery 1997 26, 629-637DOI: (10.1016/S0741-5214(97)70062-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Logistic regression analysis of patients in group II correlating a given SPP with probability of healing. Journal of Vascular Surgery 1997 26, 629-637DOI: (10.1016/S0741-5214(97)70062-4) Copyright © 1997 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions