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 Release 21.0, Jan 2008
 
Chapter : ch20. Musculoskeletal Disorders Section : Tests to Predict Healing of the Below-the-Knee Amputation
  Laser Doppler Velocimetry

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Copyright (c) 2006-2007, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

Doppler velocimetry can be used before below the knee amputation to predict if the operative wound will heal. Moving red blood cells in blood vessels cause a doppler shift of incident light which correlates with the velocity of blood flow.

 

Procedure:

• laser doppler velocimeter is used to measure cutaneous blood flow in study region

• continuous and noninvasive

 

Sites tested:

(1) anterior calf

(2) posterior calf

(3) upper arm

 

critical calf reading in mV =

= minimum (anterior calf reading in mV, posterior calf reading in mV)

 

calf-to-brachial index =

= (critical calf reading in mV) / (upper arm reading in mV)

 

Interpretation:

• If both the anterior or posterior calf reading is >= 20 mV, then the wound will heal in most (96%) patients.

• If either the anterior or posterior calf reading is < 20 mV, then the wound will probably not heal.

• The calf-to-brachial index does not offer more accuracy than the critical calf reading, but wounds that failed to heal show a lower index.

 

  References:

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

Holloway GA Jr, Burgess EM. Preliminary experiences with laser Doppler velicometry for the determination of amputation levels. Prosth Ortho Internat. 1983; 7: 63-66.

Kram HB, Appel PL, Shoemaker WC. Prediction of below-knee amputation wound healing using noninvasive laser doppler velicometry. Am J Surg. 1989; 158: 29-31.

 

 

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