AMPUTATION’S LEVEL OF LOWER LIMB IN PATIENT WITH CRITICAL ISCHEMIA

Introduction. It is an urgent problem to detect the level of lower limb amputation in patients with critical ischemia. There is often a discrepancy between the desire to preserve as a long segment of extremity as possible on the one hand and to achieve appropriate wound healing on the other. The aim of this study was to improve detecting of amputation's level of lower limb in patients with critical ischemia. Materials and methods. We examined 26 patients with foot's gangrene. We used transcutanial oxymetry (tcpO2), laser DOPPLER FLOWMETRY (LDF) and laser photople-thysmography (LPPG) to detect the level of lower limb's ampu-tation. Results. Postoperative wounds healed in 100% of cas-es if LOCAL BLOOD FLOW WAS satisfactory (segmental arterial pressure was above 60 mm Hg, signal was regular and growing more than 50% in postocclusive try, tcpO2 was above 40 mm Hg). If LOCAL BLOOD FLOW WAS not sufficient enough (segmental arterial pressure was 50-60 mm Hg, signal was irregular and turning into regular in postocclusive try, tcpO2 was 20 - 40 mm Hg) postoperative wounds healed in 40% of cases. When LOCAL BLOOD FLOW WAS UNsatisfactory the postoperative wounds didn't heal in any case. Conclusion. Findings of LPPG, LDF and tcpO2 corre-late with each other. They are good criterias to detect the level of amputation. If these testing are impossible, in doubtful situations, or a patient doesn't agree to have a trial incision, assessment of muscle's status, intensity and kind of bleeding may be useful.