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Before an amputation is performed, extensive testing is done to determine the proper level of amputation. The goal of the surgeon is to find the place where healing is most likely to be complete, while allowing the maximum amount of limb to remain for effective rehabilitation.
The greater the blood flow through an area, the more likely healing is to occur. These tests are designed to measure blood flow through the limb. Several or all of them can be done to help choose the proper level of amputation.
- measurement of blood pressure in different parts of the limb
- xenon 133 studies, which use a radiopharmaceutical to measure blood flow
- oxygen tension measurements in which an oxygen electrode is used to measure oxygen pressure under the skin If the pressure is 0, the healing will not occur. If the pressure reads higher than 40mm Hg (40 milliliters of mercury), healing of the area is likely to be satisfactory.
- laser Doppler measurements of the microcirculation of the skin
- skin fluorescent studies that also measure skin micro-circulation
- skin perfusion measurements using a blood pressure cuff and photoelectric detector
- infrared measurements of skin temperature
No one test is highly predictive of healing, but taken together, the results give the surgeon an excellent idea of the best place to amputate.
— Tish Davidson
