Amputation stump perfusion is predictive of post-operative necrotic eschar formation

Gayan S. De Silva, Khalid Saffaf, Luis A. Sanchez, Mohamed A. Zayed

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: A large proportion of patients develop poor amputation stump healing. We hypothesize that Laser-Assisted Fluorescent Angiography (LAFA) can predict inadequate tissue perfusion and healing. Methods: Over an 8-month period we reviewed all patients who underwent lower extremity amputation and LAFA. We evaluated intra-operative LAFA global and segmental stump perfusion, and post-operative modified Bates-Jensen (mBJS) wound healing scores. Results: In 15 patients, amputation stumps with lower global perfusion demonstrated higher mBJS (P = 0.01). Lower suture-line perfusion also correlated with more eschar formation (P < 0.001). Diabetic patients had higher mBJS (P = 0.009), lower stump perfusion (P = 0.02), and increased eschar volume (P < 0.001). Conclusion: LAFA is a useful adjunct for intra-operative stump perfusion assessment and can predict areas of poor stump healing and eschar formation. Diabetic patients seem to be at higher risk of stump eschar formation.

Original languageEnglish
Pages (from-to)540-546
Number of pages7
JournalAmerican journal of surgery
Volume216
Issue number3
DOIs
StatePublished - Sep 2018

Keywords

  • Amputation
  • Eschar
  • Fluorescence angiography
  • Stump perfusion

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