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 Release 21.0, Jan 2008
 
Chapter : ch20. Musculoskeletal Disorders Section : Tests to Predict Healing of the Below-the-Knee Amputation
  Skin Temperature (Thermography)

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Overview :

Measurement of skin temperature is a noninvasive technique which sometimes can predict successful amputation site healing. The warmer the skin, the more likely the amputation site will heal.

 

Measurements:

• skin temperature in °C or °F

• difference between skin temperature and ambient temperature

 

Wagner et al:

• mean temperature at skin site with successful amputation: 93.8 +/- 0.2°F

• mean temperature at skin site with revision required: 90.4 +/- 1°F

• for below the knee amputations, 50 of 52 more than 90.4°F healed; 5 of 6 below 90.4°F required revision

 

Oishi et al :

• healed amputations: cutaneous temperature 31.9 +/- 1.5°C

• healed amputations: (cutaneous temperature) - (ambient temperature) 7.0 +/- 1.7°C

• failed amputations: cutaneous temperature: 30.5 +/- 2.2°C

• failed amputations: (cutaneous temperature) - (ambient temperature): 6.5 +/- 2.5°C

• In 13 of 14 patients with skin temperature between 30.5 and 32°C, the amputation site healed.

 

Data in Oishi et al

Cutaneous Temperature > 32°C or < 30.5°C

(Temperature at Site) - (Ambient Temperature) >= 5°C

sensitivity

68

83

specificity

50

33

accuracy

67

78

positive predictive value

94

92

negative predictive value

11

17

 

De Frang et al:

• if skin temperature is > 30°C, 80-90% of amputation sites will heal

• if skin temperature is < 30°C, 50% of amputation sites will heal

 

  References:

De Frang RD, Taylor LM Jr, Porter JM. Basic data related to amputations. Ann Vasc Surg. 1991; 5: 202-207.

Oishi CS, Fronek A, Golbranson FL. The role of non-invasive vascular studies in determining the levels of amputation. J Bone Joint Surg. 1988; 70A: 1520-1530.

Wagner WH, Keagy BA, et al. Noninvasive determination of healing of major lower extremity amputation: The role of clinical judgment. J Vasc Surg. 1988; 8: 703-710.

 

 

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