Objectives: This study intended to confirm whether skin perfusion pressure (SPP) could predict the outcome of ischemic wound healing. Patients and methods: Sixty-two limbs in 53 patients with conservative therapy were enrolled in this study. A SPP value of 40 mmHg was adopted as the criterion for making clinical decisions. The outcome one month after SPP measurement was classified as "improved" (diameter of ulcer decreased ≥ 20% or demarcation of gangrene became well defined) or "no change or worse" (others), and the fate of wound was classified as "healed" or "not healed". The evaluated influential factors on the outcome at one month included age, sex, presence of arteriosclerosis obliterans, collagen disease, hypertension, diabetes mellitus, hemodialysis, wound infection, wound management, and SPP ≥ 40 mmHg. Results: Using a criterion of SPP ≥ 40 mmHg, the outcome at one month could be predicted with a sensitivity: of 75.0%, a specificity: of 82.6%, and an accuracy: of 80.6%. The receiver operating characteristic curve indicated our criterion to be appropriate. Logistic regression analysis showed SPP ≥ 40 mmHg to be an independent factor (P < 0.0001) with the odds ratio of 14.2 (95% CI 3.6-55.8). Conclusions: SPP, using a cutoff value of 40 mmHg, can predict the ischemic wound healing with conservative therapy.
Plantar flexion test showed good reliability and correlation. Plantar flexion may serve as an alternative to treadmill testing in evaluating muscle pain in patients with intermittent claudication.
Aim:To assess the utility of skin perfusion pressure (SPP) measurement in evaluating the outcome of vascular constructions for critical limb ischemia (CLI) patients. Methods: We retrospectively studied 19 lower limbs in 18 patients who underwent arterial reconstruction for CLI from whom SPP measurements had been obtained pre-and postoperatively between 2008 and 2010. Six limbs whose ulcers had healed postoperatively were classified into group H, 7 limbs whose ulcers had not healed into group U, and 6 limbs without ulcers into group N. SPP values were compared among these groups. Results: The preoperative SPP values in all groups were <30 mmHg, without significant differences among the groups. The SPP values in groups H and N significantly improved after operation, and those in group U were significantly lower than those in the other groups. Conclusions: SPP measurement before and after arterial reconstruction is useful to assess improvement in tissue circulation and to predict the likelihood of wound healing. An SPP value ≥30 mmHg was considered necessary for wound healing, supporting the findings of the few reports in the literature on the usefulness of SPP for assessing vascular reconstruction effects on ulcer wound healing.
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