A comparison of laser Doppler fluxmetry and transcutaneous oxygen pressure measurement in the dysvascular patient requiring amputation. 1998

M Mars, and A McKune, and J V Robbs
Department of Physiology, University of Natal Medical School, South Africa.

OBJECTIVE To determine the predictive power of laser Doppler fluxmetry (LDF), both heated and unheated, as a preoperative investigation of wound healing potential in dysvascular patients requiring amputation, by comparison with transcutaneous oxygen pressure measurement (TcpO2) and the limb to chest TcpO2 index. METHODS Thirty-five non-diabetic patients with peripheral vascular disease were investigated before amputation. Heated and unheated LDF and heated TcpO2 measurements were taken on the chest wall and at the routine above-knee, below-knee and mid-foot amputation levels. Wound healing potential was evaluated against a TcpO2 index value of 0.55 and on clinical outcome. RESULTS A heated LDF value of 4.9 arbitrary units (au) was shown by receiver-operator characteristic curve to have the best predictive power, with an overall accuracy for preoperative prediction of wound healing of 91.4%, and a predictive value for wound failure of 89%. Based on the heated LDF of 4.9 au, review of 26 amputations performed shows the overall accuracy for preoperative prediction of wound healing of 92.3%, a predictive value for wound healing of 100%, and a predictive value for wound failure of 62.5%. CONCLUSIONS A heated LDF value of 4.9 au appears to be a useful predictor of the potential of an amputation site to heal.

UI MeSH Term Description Entries
D007866 Leg The inferior part of the lower extremity between the KNEE and the ANKLE. Legs
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D001785 Blood Gas Monitoring, Transcutaneous The noninvasive measurement or determination of the partial pressure (tension) of oxygen and/or carbon dioxide locally in the capillaries of a tissue by the application to the skin of a special set of electrodes. These electrodes contain photoelectric sensors capable of picking up the specific wavelengths of radiation emitted by oxygenated versus reduced hemoglobin. Carbon Dioxide Partial Pressure Determination, Transcutaneous,Cutaneous Oximetry,Oximetry, Transcutaneous,Oxygen Partial Pressure Determination, Transcutaneous,Transcutaneous Blood Gas Monitoring,Transcutaneous Capnometry,Transcutaneous Oximetry,PtcO2,TcPCO2,Capnometries, Transcutaneous,Capnometry, Transcutaneous,Cutaneous Oximetries,Oximetries, Cutaneous,Oximetries, Transcutaneous,Oximetry, Cutaneous,Transcutaneous Capnometries,Transcutaneous Oximetries
D003627 Data Interpretation, Statistical Application of statistical procedures to analyze specific observed or assumed facts from a particular study. Data Analysis, Statistical,Data Interpretations, Statistical,Interpretation, Statistical Data,Statistical Data Analysis,Statistical Data Interpretation,Analyses, Statistical Data,Analysis, Statistical Data,Data Analyses, Statistical,Interpretations, Statistical Data,Statistical Data Analyses,Statistical Data Interpretations
D006358 Hot Temperature Presence of warmth or heat or a temperature notably higher than an accustomed norm. Heat,Hot Temperatures,Temperature, Hot,Temperatures, Hot
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000671 Amputation, Surgical The surgical removal of part of, or all of, a limb or other appendage or outgrowth of the body. Amputation,Amputation, Multiple, Surgical,Multiple Amputation, Surgical,Surgical Amputation Procedures,Amputation Procedure, Surgical,Amputation Procedures, Surgical,Amputation, Surgical Multiple,Amputations,Amputations, Surgical,Amputations, Surgical Multiple,Multiple Amputations, Surgical,Procedure, Surgical Amputation,Procedures, Surgical Amputation,Surgical Amputation,Surgical Amputation Procedure,Surgical Amputations,Surgical Multiple Amputation,Surgical Multiple Amputations
D000672 Amputation Stumps The part of a limb or tail following AMPUTATION, SURGICAL that is proximal to the amputated section. Amputation Stump,Stump, Amputation,Stumps, Amputation
D014945 Wound Healing Restoration of integrity to traumatized tissue. Healing, Wound,Healings, Wound,Wound Healings
D016491 Peripheral Vascular Diseases Pathological processes involving any one of the BLOOD VESSELS in the vasculature outside the HEART. Peripheral Angiopathies,Vascular Diseases, Peripheral,Diseases, Peripheral Vascular,Angiopathies, Peripheral,Angiopathy, Peripheral,Disease, Peripheral Vascular,Peripheral Angiopathy,Peripheral Vascular Disease,Vascular Disease, Peripheral

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