Preamputation evaluation of limb perfusion with laser Doppler imaging and transcutaneous gases

Stephen F. Figoni, Oscar U. Scremin, Charles F. Kunkel, Dorene Opava-Rutter, Jessica Johnson, Eric D. Schmitter, A. M.Erika Scremin

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

We studied 31 subjects with severe leg ischemia and 29 age-matched nonischemic control subjects to compare preamputation assessments of leg ischemia using laser Doppler imaging (LDI), transcutaneous partial pressure of oxygen (TcPO2), and transcutaneous partial pressure of carbon dioxide (TcPCO2). TcPO2 and TcPCO2 were evaluated with Novametrix Medical Systems, Inc, monitors (Wallingford, Connecticut) and perfusion (flux) of skin topically heated to 44°C, and adjacent nonheated areas were evaluated with a Moor Laser Doppler Imager (Moor Instruments, Ltd; Devon, England). LDI flux of heated areas, its ratio to nonheated areas, and TcPO2 (not TcPCO2) were lower in ischemic subjects than in control subjects. LDI flux ratio performed better than TcPO2 in identifying ischemia, with fewer false positive and false negative results. Moreover, LDI flux of heated skin detected a proximal to a distal gradient of perfusion in ischemic subjects, while TcPO2 did not. LDI was superior to TcPO2 in discriminating correctly between ischemic and nonischemic skin. The results suggest that an LDI ratio below 5 indicates nonviable skin.

Original languageEnglish (US)
Pages (from-to)891-904
Number of pages14
JournalJournal of Rehabilitation Research and Development
Volume43
Issue number7
DOIs
StatePublished - Nov 2006
Externally publishedYes

Keywords

  • Amputation
  • Blood gas monitoring
  • Ischemia
  • Laser Doppler flowmetry
  • Leg
  • Oxygen
  • Perfusion
  • Peripheral vascular diseases
  • Rehabilitation
  • Transcutaneous

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