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
The authors conducted a retrospective, observational study of 307 patients who underwent partial foot amputation
and had noninvasive arterial studies in the perioperative period.
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.
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
measurements are useful but should not be used in isolation to make treatment decisions regarding amputation