A rationale for skew flaps in below-knee amputation surgery.
The use of thermography in the assessment of amputation levels has demonstrated a medial to lateral thermal gradient in many cases. In order to see whether this reflected a true medial to lateral skin blood flow gradient, a prospective study was set up to measure blood flow medially and laterally below the knee. Twenty-one patients, presenting for amputation assessment with end-stage peripheral vascular disease, were studied. Skin blood flows were measured using an intradermal radioisotope clearance technique. Results showed a highly significant difference between medial and lateral skin blood flows (t = 4.79; p less than 0.001). In view of the significantly higher blood flow in the medial skin of the lower leg, it is suggested that a more medially based posterior below-knee amputation skin flap may be of more value in some patients.
D000368:Aged; D000671:Amputation, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D007511:Ischemia / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply*; D013524:Surgical Flaps; D013817:Thermography