A COMPARISON OF LASER-DOPPLER FLUXMETRY AND TRANSCUTANEOUS OXYGEN-PRESSURE MEASUREMENT IN THE DYSVASCULAR PATIENT REQUIRING AMPUTATION

Objective: To determine the predictive power of laser Doppler fluxmetr y (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 (TcpO(2) ) and the limb to chest TcpO(2) index. Methods: Thirty-five non-diabet ic patients with peripheral vascular disease were investigated before amputation. Heated and unheated LDF and heated TcpO(2) measurements we re taken on the chest wall and at the routine above-knee, below-knee a nd mid-foot amputation levels. Wound healing potential was evaluated a gainst a TcpO(2) 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 hea ted LDF of 4.9 an, review of 26 amputations performed shows the overal l accuracy for preoperative prediction of wound healing of 92.3%, a pr edictive value for wound healing of 100%, and a predictive value for w ound failure of 62.5%. Conclusion: A heated LDF value of 4.9 an appear s to be a useful predictor of the potential of an amputation site to h eal.