0
Articles   |    
The role of non-invasive vascular studies in determining levels of amputation

The Journal of Bone & Joint Surgery.  1988; 70:1520-1530 
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case
text A A A

Abstract

Various non-invasive vascular studies have been reported to provide valuable data for selection of the optimum level of amputation in limbs in patients who have vascular disease. We evaluated three such methods: (1) measurement of the change in the transcutaneous PO2 after inhalation of oxygen; (2) determination, by the Doppler method, of segmental blood pressure; and (3) measurement of the temperature of the skin. The records of eighty patients (ninety amputations) were retrospectively reviewed for correlations between the results of the vascular studies and the outcome of the amputation. Measurement of transcutaneous PO2 was found to be the most accurate predictor of successful healing of an amputation; the other two measurements were less reliable. The values for transcutaneous PO2 both at rest and after inhalation of oxygen were significantly different (p less than 0.001) for the patients who had a healed amputation compared with those who had a failed amputation. Regardless of the initial value, if, after inhalation of oxygen, the transcutaneous PO2 reached ten millimeters of mercury or more, it predicted healing of the amputation stump with a sensitivity of 98 per cent. When the level of amputation was selected on the basis of clinical judgment at the time of operation, the sensitivity was only 90 per cent.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

    Topics

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe




    Related Articles
    Related Cases
    Related Content
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    jbjs jobs
    12/22/2011
    VA - Charleston Area Medical Center
    12/22/2011
    ME - Central Maine Medical Center
    12/22/2011
    Maine - Central Maine Medical Center