Determination of amputation level in ischaemic limbs using tcPO<sub>2</sub> measurement

Poredoš, Pavel; Rakovec, S; Guzic-Salobir, B

doi:10.1024/0301-1526.34.2.108

Cited by 49 publications

(24 citation statements)

References 11 publications

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“…By the year 2000, Misuri et al 36 validated that the accuracy threshold of TcPO2 is 20 mm Hg again in 30 lower limbs of 20 patients. In 2005, Poredos et al 37 measured TcPO2 on the dorsum of the foot and 10 cm below the knee on 56 patients before surgery to identify the lower threshold value of TcPO2. Their results were that when TcPO2 value ranged from 25 mm Hg to 36 mm Hg, the reamputation rate was 15% due to the nonhealing wound and the minimal TcPO2 value to anticipate the healing of residual limb was 15 mm Hg.…”

Section: Amputation Level Determinationmentioning

confidence: 99%

Review: Hemodynamic Studies for Lower Limb Amputation and Rehabilitation

Dong

Jiang

Zhang

et al. 2015

J. Mech. Med. Biol.

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No matter what the reason and level of amputation are, amputees will face many complex postoperative problems and potential complications. From the perioperative stage to lengthy rehabilitation process, patients need comprehensive and cautious therapies to help them rebuild their physical and mental health. Although there is some scattered information, the achievements of hemodynamic study for lower limb amputation and rehabilitation have not been systematically classified and summarized. The purpose of this review is to introduce and discuss the hemodynamic issues in preoperative diagnosis, surgical techniques and postoperative problems in the past two decades. Whether from clinical or biomechanical perspective, the investigations of the former two stages have been relatively mature and gained some clear outcomes, even if some conclusions are conflicting and controversial. While in terms of the postoperative problems, such as the common pressure ulcers, DTI and muscle atrophy, there is a lack of vascular or blood flow state studies specifically for lower residual limb. Therefore, the future research focus of hemodynamics for lower limb amputation should probably be the detailed investigations on the relationships between various blood flow parameters and certain common complications. Although hemodynamic research has made some achievements at this stage, it is believed that more advanced and reliable techniques are pending for further explorations and developments.

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Section: Amputation Level Determinationmentioning

confidence: 99%

Review: Hemodynamic Studies for Lower Limb Amputation and Rehabilitation

Dong

Jiang

Zhang

et al. 2015

J. Mech. Med. Biol.

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“…72 In vascular disease management, peripheral blood flow measurement has a long history of use in determining the level of lower limb amputation. 73,74 In the field of PU management, blood flow monitoring has largely been limited to research applications. [75][76][77][78] However, Coggrave and Rose showed that transcutaneous blood oxygen measurement can readily be incorporated into clinical seating evaluations and can provide valuable insights for improving PU prevention practice.…”

Section: Blood Flow Measurement: Tissue Oxygen and Blood Flowmentioning

confidence: 99%

Interdisciplinary Essentials in Pressure Ulcer Management

Fehlings¹,

Boakye²,

Ditunno³

et al. 2013

Essentials of Spinal Cord Injury

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To successfully prevent pressure ulcer (PU) formation, it is essential to understand the fundamental concept that there are multiple intrinsic and extrinsic factors leading to the development of PUs. Having a PU not only greatly impacts a person's quality of life, it also places a heavy burden on the health care system in treatment costs. 1 Recent trends in health care delivery suggest a comprehensive mul-tidisciplinary approach to achieve successful wound management outcomes. 2 The team typically includes physicians, nurses, physical therapists, occupational therapists, dietitians, and psychologists, together with some input from biomedical engineers (Fig. 15.1). This chapter addresses the essentials of PU management from the perspectives of a multidisciplinary PU management team. Key Points1. Effective pressure ulcer (PU) management requires consideration of multiple intrinsic and extrinsic factors. 2.A comprehensive multidisciplinary approach is essential to achieve successful PU management outcomes. Individual members of the multidisciplinary team contribute their own expertise while collaborating and communicating with other team members about risk modification. 3.Many pressure ulcers are preventable with the use of appropriate, currently available interventions. The clinician's focus is on modification of as many medical risk factors as possible. The nursing process facilitates assessment and evaluation of PU status and assists in determining new strategies. Physical, occupational, and other rehabilitation therapists develop individualized, comprehensive plans for pressure management based on patient and family education together with assessment and selection of support surfaces and positioning devices for effective pressure relief. Nutrition, psychosocial status, and patient education are all critical factors in PU prevention and management.

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“…No contexto clínico as variáveis microcirculatórias são utilizadas como ferramentas de prognóstico para avaliar a isquémia grave dos membros [8] , a evolução da ferida cutânea [9] e, até para determinar o nível de amputação. [10] A Fluxometria por Laser Doppler (FLD), a Gasimetria Transcutânea e a Evaporimetria são tecnologias amplamente utilizadas que permitem uma avaliação sensível, contínua, não-invasiva e em tempo real de variáveis relacionadas com a circulação. [11][12][13][14] Estas técnicas são normalmente associadas a testes de provocação que podem estimular a reatividade vascular e, portanto, investigar a resposta fisiológica evocada sob controlo.…”

Section: Introductionunclassified

“…[7] Clinically, microcirculatory variables are also used as prognostic tools to assess severe limb ischemia, [8] wound outcome [9] and also to eventually determine the amputation level. [10] Laser Doppler Flowmetry (LDF), Transcutaneous Gasimetry and Evaporimetry are extensively used technologies that enable sensitive, continuous, non-invasive and real-time assessment of circulation related variables. [11][12][13][14] Frequently, these techniques are coupled with provocation tests to stimulate vascular reactivity and therefore to investigate the physiological response evoked under control.…”

Section: Introductionmentioning

confidence: 99%

Exploring the oxygen challenge test as a microcirculation evaluation model

Silva

Ferreira

Buján

et al. 2013

BBR

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Biomedical and Biopharmaceutical Research J o r n a l d e I n v e s t i g a ç ã o B i o m é d i c a e B i o f a r m a c ê u t i c a Exploring the oxygen challenge test as a microcirculation evaluation model AbstractCutaneous microcirculation has emerged in recent years as a practical accessible subject for the study of peripheral circulation. Non-invasive techniques such as Laser Doppler Flowmetry (LDF), skin Evaporimetry and Transcutaneous Gasimetry in association with provocation tests, render cutaneous circulation a very attractive research model. This study was applied to a group of healthy young female volunteers, (n = 8, (21,6 ± 2,6) years old) breathing a 100 % oxygen atmosphere for 10 minutes. This test allowed us to evaluate the circulatory response in the lower limb microcirculation. Measurement techniques included local blood flow by LDF, Transcutaneous (tc) pO 2 partial pressure and Transepidermal Water Loss (TEWL) by Evaporimetry. Data analysis revels that tc-pO 2 and LDF changed significantly during the test. A reciprocal evolution profile was registered in LDF and TEWL, which seems to support previous data that changes in local blood flow may influence the epidermal "barrier" function. This model seems suitable to characterize the lower limb microcirculation.Keywords: LDF, tc-pO 2 , oxygen breathing, hyperoxia, TEWL ResumoA microcirculação cutânea surgiu, nos últimos anos, como uma alternativa pratica e acessível para o estudo da circulação periférica. Técnicas não-invasivas, como a Fluxometria por Laser Doppler (FLD), a Evaporimetria e a Gasimetria transcutânea em associação a testes de provocação têm transformado a circulação cutânea num atraente modelo de investigação. Este estudo foi aplicado a um grupo de voluntárias jovens saudáveis (n = 8, (21,6 ± 2,6) anos) respirando uma atmosfera de 100 % oxigénio durante 10 minutos. Este teste permitiu-nos avaliar a resposta circulatória na microcirculação do membro inferior. As técnicas de medição incluíram o fluxo sanguíneo local por FLD, a pO 2 transcutânea (tc) e a Perda Transepidérmica de Água (PTEA) por evaporimetria. A análise de dados revela que tc-pO 2 e FLD se alteraram significativamente durante o teste. Um perfil de evolução recíproca foi registrado para FLD e PTEA, que parece apoiar dados anteriores de que as alterações no fluxo sanguíneo local podem influenciar a função de "barreira" epidérmica. Este modelo parece adequado para caracterizar a microcirculação do membro inferior in vivo.Palavras-chave: FLD, tc-pO 2 , respiração de oxigénio, hiperóxia, PTEA

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Determination of amputation level in ischaemic limbs using tcPO₂ measurement

Abstract: Our study showed that tcPO2 is a reliable indicator of local ischemia. The integration of this parameter with other personal clinical criteria may be a valuable help to the surgeon in decision making.

Cited by 49 publications

References 11 publications

Review: Hemodynamic Studies for Lower Limb Amputation and Rehabilitation

Review: Hemodynamic Studies for Lower Limb Amputation and Rehabilitation

Interdisciplinary Essentials in Pressure Ulcer Management

Exploring the oxygen challenge test as a microcirculation evaluation model

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Determination of amputation level in ischaemic limbs using tcPO2 measurement

Abstract: Our study showed that tcPO2 is a reliable indicator of local ischemia. The integration of this parameter with other personal clinical criteria may be a valuable help to the surgeon in decision making.

Cited by 49 publications

References 11 publications

Review: Hemodynamic Studies for Lower Limb Amputation and Rehabilitation

Review: Hemodynamic Studies for Lower Limb Amputation and Rehabilitation

Interdisciplinary Essentials in Pressure Ulcer Management

Exploring the oxygen challenge test as a microcirculation evaluation model

Contact Info

Product

Resources

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Determination of amputation level in ischaemic limbs using tcPO₂ measurement