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Noninvasive arterial studies including transcutaneous oxygen pressure measurements with the limbs elevated or dependent to predict healing after partial foot amputation.
Am J Phys Med Rehabil 2013; 92(5):385-92AJ

Abstract

OBJECTIVE

Noninvasive arterial studies have been used to determine level of amputation. The objective of this study was to examine each component of the noninvasive arterial studies to determine optimal cut points to predict healing and to evaluate whether physiologic maneuvers could improve the utility of transcutaneous oxygen pressure (TcPO2) values to predict healing of partial foot amputation.

DESIGN

The authors conducted a retrospective, observational study of 307 patients who underwent partial foot amputation and had noninvasive arterial studies in the perioperative period.

RESULTS

The TcPO2 values were significantly predictive of healing. Specifically, a cut point TcPO2 value of 38 mm Hg had a sensitivity and a specificity of 71% for predicting healing or failure. The optimal cut point was mostly unaffected by patient characteristics. The addition of noninvasive arterial studies recorded in a position with the limb elevated improved prediction in the subgroup with supine TcPO2 values of 38 mm Hg or lower.

CONCLUSIONS

The findings of this study validate previous reports and confirm that TcPO2 measurements are valuable to more accurately determine the correct amputation level and, in turn, obtain better outcomes. TcPO2 measurements may provide better prognostic value than do ankle-brachial indices for healing after partial foot amputation. TcPO2 measurements are useful but should not be used in isolation to make treatment decisions regarding amputation level.

Authors+Show Affiliations

Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23478457

Citation

Andrews, Karen L., et al. "Noninvasive Arterial Studies Including Transcutaneous Oxygen Pressure Measurements With the Limbs Elevated or Dependent to Predict Healing After Partial Foot Amputation." American Journal of Physical Medicine & Rehabilitation, vol. 92, no. 5, 2013, pp. 385-92.
Andrews KL, Dib MY, Shives TC, et al. Noninvasive arterial studies including transcutaneous oxygen pressure measurements with the limbs elevated or dependent to predict healing after partial foot amputation. Am J Phys Med Rehabil. 2013;92(5):385-92.
Andrews, K. L., Dib, M. Y., Shives, T. C., Hoskin, T. L., Liedl, D. A., & Boon, A. J. (2013). Noninvasive arterial studies including transcutaneous oxygen pressure measurements with the limbs elevated or dependent to predict healing after partial foot amputation. American Journal of Physical Medicine & Rehabilitation, 92(5), pp. 385-92. doi:10.1097/PHM.0b013e3182876a06.
Andrews KL, et al. Noninvasive Arterial Studies Including Transcutaneous Oxygen Pressure Measurements With the Limbs Elevated or Dependent to Predict Healing After Partial Foot Amputation. Am J Phys Med Rehabil. 2013;92(5):385-92. PubMed PMID: 23478457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Noninvasive arterial studies including transcutaneous oxygen pressure measurements with the limbs elevated or dependent to predict healing after partial foot amputation. AU - Andrews,Karen L, AU - Dib,Mansour Y, AU - Shives,Thomas C, AU - Hoskin,Tanya L, AU - Liedl,David A, AU - Boon,Andrea J, PY - 2013/3/13/entrez PY - 2013/3/13/pubmed PY - 2013/6/20/medline SP - 385 EP - 92 JF - American journal of physical medicine & rehabilitation JO - Am J Phys Med Rehabil VL - 92 IS - 5 N2 - OBJECTIVE: Noninvasive arterial studies have been used to determine level of amputation. The objective of this study was to examine each component of the noninvasive arterial studies to determine optimal cut points to predict healing and to evaluate whether physiologic maneuvers could improve the utility of transcutaneous oxygen pressure (TcPO2) values to predict healing of partial foot amputation. DESIGN: The authors conducted a retrospective, observational study of 307 patients who underwent partial foot amputation and had noninvasive arterial studies in the perioperative period. RESULTS: The TcPO2 values were significantly predictive of healing. Specifically, a cut point TcPO2 value of 38 mm Hg had a sensitivity and a specificity of 71% for predicting healing or failure. The optimal cut point was mostly unaffected by patient characteristics. The addition of noninvasive arterial studies recorded in a position with the limb elevated improved prediction in the subgroup with supine TcPO2 values of 38 mm Hg or lower. CONCLUSIONS: The findings of this study validate previous reports and confirm that TcPO2 measurements are valuable to more accurately determine the correct amputation level and, in turn, obtain better outcomes. TcPO2 measurements may provide better prognostic value than do ankle-brachial indices for healing after partial foot amputation. TcPO2 measurements are useful but should not be used in isolation to make treatment decisions regarding amputation level. SN - 1537-7385 UR - https://www.unboundmedicine.com/medline/citation/23478457/Noninvasive_arterial_studies_including_transcutaneous_oxygen_pressure_measurements_with_the_limbs_elevated_or_dependent_to_predict_healing_after_partial_foot_amputation_ L2 - http://dx.doi.org/10.1097/PHM.0b013e3182876a06 DB - PRIME DP - Unbound Medicine ER -