Toe blood pressure by photo plethysmography: An index of healing in forefoot amputation

Bone, G; Pomajzl, Mary J.

doi:10.1097/00006534-198111000-00101

Cited by 16 publications

(42 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Paaske & Tonnesen (1980) found that digital pressures below 10 mm Hg were associated with an 82 per cent risk of amputation, and Barnes (in discussing the paper by Gibbons et al 1979) stated that minor amputations of the feet healed in non-diabetics at digital pressures above 10 mm Hg and that diabetics failed to heal when the digital pressure was below 25 mm Hg. The above data on digital healing pressures are consistent, but critical healing values of SDBP of as high as 45 mm Hg have also been reported in series of diabetics (Carter 1973, Bone & Pomajzl 1981. The present paper confirms our previous findings (Holstein & Lassen 1980), i.e.…”

Section: Discussionsupporting

confidence: 92%

“…The ankle pressure is the most widely used parameter. Some authors have found the ankle pressure to be valuable (Carter 1973, Raines et al 1976, Verta et al 1976, Baker & Barnes 1977, Wagner & Buggs 1978, Holstein & Lassen 1980, Nicholas et al 1982, while other authors have found it less useful (Gibbons et al 1979, Mehta et al 1980, Bone & Pomajzl 1981. A gray zone of healing is poorly defined and failures are not infrequent at high pressures, either because of infection or because ankle pressures are estimated too high at medial sclerosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The distal blood pressure predicts healing of amputations on the feet

Holstein

1984

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

The healing of digital and transmetatarsal forefoot amputations was compared with the systolic digital and ankle blood pressure, both measured with a strain-gauge, and with the skin perfusion pressure on the forefoot measured with the isotope washout technique. In 85 out of 134 legs (63 per cent) the amputation healed. The frequency of healing correlated statistically significantly with all three measures of distal blood pressures, the closest correlation being with the systolic digital blood pressure (SDBP). As measured in 110 cases the healing rates were: SDBP < 20 mm Hg: four out of 23; SDBP 20-29 mm Hg: 13 out of 22; SDBP 2 30 mm Hg: 51 out of 65. Ankle pressures and skin perfusion pressures were less useful. Invasive infection was present in 40 out of 102 diabetic legs and, next to ischaemia, was the major determinant of the healing results.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The distal blood pressure predicts healing of amputations on the feet

Holstein

1984

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

show abstract

“…Toe pressures measured with plethysmography may be a more accurate reflection of blood supply to the foot (143) and may provide better prediction of wound healing than ankle pressure or AAI (122,144,145). However, toe pressures measured with pulse-volume recordings are thought to have poor reproducibility (137), especially in the presence of autonomic neuropathy (146).…”

Section: Peripheral Vascular Diseasementioning

confidence: 99%

Preventive Foot Care in People With Diabetes

et al. 1998

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that ankle pressure levels <50-80 mmHg indicate poor wound healing or healing only after major amputation (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). The predictive value of ankle pressure has, however, not been confirmed by others (16)(17)(18)(19)(20). An ischemic index between blood pressure levels in the ankle and brachial arteries has also been used.…”

mentioning

confidence: 99%

“…This can be avoided when systolic toe pressure is used. Toe pressure levels 25-30 and up to 50-55 mmHg have been found to indicate a good prognosis for wound healing, whereas healing did not occur with pressures <20 to 40-45 mmHg (5,6,8,9,17,23,24). Inotherstudies, however, toe pressure did not predict wound healing (7,19).…”

mentioning

confidence: 99%

Prognostic Value of Systolic Ankle and Toe Blood Pressure Levels in Outcome of Diabetic Foot Ulcer

et al. 1989

View full text Add to dashboard Cite

The prognostic value of distal blood pressure measurements has been studied in 314 consecutive diabetic patients with foot ulcers. Systolic toe blood pressure was measured with a strain-gauge technique, and ankle pressure was measured with strain-gauge or Doppler techniques. Wound healing was defined as intact skin for at least 6 mo. One hundred ninety-seven patients healed primarily, 77 had amputations, and 40 died before healing had occurred. In 294 of 300 patients, it was possible to measure either ankle or toe pressure. Fourteen patients were not available for pressure measurements. Of these, 10 patients healed primarily, and 4 died before healing occurred. Both ankle and toe pressures were higher (P less than .001) among patients who healed without amputation compared with those who underwent amputation or died before healing. No differences were seen in ankle or toe pressure levels among those who had amputations or died. No patient healed primarily with an ankle pressure less than 40 mmHg. An upper limit above which amputation was not required could not be defined. Primary healing was achieved in 139 of 164 patients (85%) with a toe pressure level greater than 45 mmHg, whereas 43 of 117 patients (36%; P less than .001) healed without amputation when toe pressure was less than or equal to 45 mmHg. In conclusion, a combination of ankle and toe pressure measurements is a useful tool to predict primary healing in diabetic foot ulcers.

show abstract

Toe blood pressure by photo plethysmography: An index of healing in forefoot amputation

Cited by 16 publications

References 0 publications

The distal blood pressure predicts healing of amputations on the feet

The distal blood pressure predicts healing of amputations on the feet

Preventive Foot Care in People With Diabetes

Prognostic Value of Systolic Ankle and Toe Blood Pressure Levels in Outcome of Diabetic Foot Ulcer

Contact Info

Product

Resources

About