Transcutaneous partial oxygen pressure changes following skew flap and Burgess-type below-knee amputations.
OBJECTIVE
To evaluate the degree of flap hypoxia following different types of below-knee amputations.


METHODS
Prospective preoperative and postoperative measurements of transcutaneous partial oxygen pressure (TcPo2) at the site of amputation in 10 consecutive patients who underwent a Burgess-type below-knee amputation (group 1) and in 10 consecutive patients who underwent a skew flap amputation (group 2).


METHODS
An academic, tertiary care Veterans Affairs medical center.


METHODS
Individuals with severe arterial occlusive disease of the lower extremity, in many of whom vascular reconstruction has failed.


METHODS
Measurements of TcPo2 (in millimeters of mercury).


METHODS
The decrease in TcPo2 associated with the different "flaps" of a Burgess-type below-knee amputation.


RESULTS
In all skin flaps, regardless of the type of amputation, an early postoperative reduction of the TcPo2 was noted. The greatest reduction (11 mm Hg) and persistence at 20 postoperative days were noted in posterior flaps.


CONCLUSIONS
Strict conformity to the Burgess-type of below-knee flap design may not provide an optimal incisional blood supply. Consideration should be given to the skew flap technique in patients who require amputation for severe lower limb arterial insufficiency.
Johnson
W C
WC
Department of Surgery, Boston Veterans Affairs Medical Center, Boston University School of Medicine, Mass, USA.
Watkins
M T
MT
Hamilton
J
J
Baldwin
D
D
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000379:methods*; D001785:Blood Gas Monitoring, Transcutaneous; D006801:Humans; D007717:Knee; D007866:Leg / Q000098:blood supply* / Q000601:surgery*; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000097:blood* / Q000601:surgery*; D011300:Preoperative Care; D011446:Prospective Studies; D013524:Surgical Flaps / Q000098:blood supply*