Ar. Poynton et K. O'Rourke, An analysis of skin perfusion over the Achilles tendon in varying degrees of plantarflexion, FOOT ANKL I, 22(7), 2001, pp. 572-574
Delayed wound healing and, less commonly, wound breakdown are significant c
omplications following open Achilles tendon repair. Skin perfusion over the
Achilles tendon may be reduced when the ankle is plantarflexed. The aim of
this study was to analyse skin perfusion over the Achilles tendon with the
ankle in varying degrees of plantarflexion in 20 volunteers. Skin perfusio
n was determined by measuring the transcutaneous skin oxygen pressure (tcPO
2) using the Novametrix TcO2M 860 monitor. Measurements were taken at the m
edial edge of the Achilles tendon in 20 volunteers.
Skin perfusion was maximal with the ankle plantarflexed to 20 degrees. With
plantarflexion beyond this skin perfusion was reduced. At 40 degrees plant
arflexion skin perfusion was reduced by up to 49% (mean 35%, range 27% to 4
9%). We conclude plantarflexion beyond 20 degrees reduces skin perfusion in
the region of the Achilles tendon. Though this study was performed on non-
operated cases, and is thus limited, the findings may have clinical implica
tions with regard to cast position following Achilles tendon repair.