Lower Limb Perfusion Asymmetries in Humans at Rest and Following Activity—A Collective View

The significance of lower limb perfusion asymmetries remains unknown in healthy individuals. Our study aims to understand how factors such as posture, sex, age, and body weight relate to perfusion. Data from studies previously published by our group, including experiments using laser Doppler flowmetry as the gold standard for perfusion measurements in baseline, (various) challenge, and recovery phases was assembled from a total of 139 healthy participants. Body position was shown to be a primary determinant of perfusion asymmetry, especially in women. Effects of sex and age were also analyzed. In a supine position, perfusion asymmetries seemed to relate negatively in the aged group of participants, where challenge and recovery seemed to follow different processes. In the upright position, young men and women have shown comparable distributions and asymmetry ratios at baseline and recovery. In the aged group, differences between sexes were observed at baseline, but again, the course of the asymmetry ratios with challenge was essentially similar in men and women. Our analysis suggests that ageing is a critical determinant in our upright study sample, as higher baseline asymmetries and longer recoveries after challenge were linked in older males with higher body mass index (BMI).

Vascular Assessment of the Lower Extremity with a Chronic Wound

Peripheral arterial disease (PAD) affects many individuals worldwide and is associated with increased morbidity and mortality. Controversy exists on whether or not to screen asymptomatic patients. Further complicating this is that many patients with a chronic lower extremity wound are often asymptomatic. PAD and traditional noninvasive vascular studies may be inaccurate in providing a correct diagnosis. A review of current and novel vascular assessment modalities along with their benefits and limitations are presented here. A combination of these vascular assessments may help improve accuracy in diagnosis, providing timely care to those patients in need.

Distal bypass to a critically ischemic foot increases the skin perfusion pressure at the opposite site of the distal anastomosis

INTRODUCTION

The purpose of the study was to reveal the effect of blood flow supply to the foot by analyzing the skin perfusion pressure values and the pedal arch connection after bypass surgery.

PATIENTS AND METHODS

We selected 48 operated limbs whose skin perfusion pressure was measured pre- and post-operatively on the opposite site of distal anastomosis. We also assigned the ischemic limbs to three groups according to the patency of the pedal arch: good, intermediate, and poor.

RESULTS

The mean value of skin perfusion pressure increased significantly from 27.0 ± 14.9 to 52.8 ± 16.0 (p < 0.001) post-operatively. Skin perfusion pressure improved in most of the limbs post-operatively and decreased or unchanged in only four limbs, all of which showed improved tissue loss. Three amputated limbs were due to infection, and all showed an increase in skin perfusion pressure.

CONCLUSION

It was difficult to correlate limb prognosis to skin perfusion pressure and the pedal arch connection.