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A substantial number of patients with rest pain, ulceration or gangrene are unable to undergo current non-invasive perfusion testing—Could another modality be utilised?

Odette Hart, Qiantai Hong, Khai Tuck Lee, Sinead Gormley, Peta Tehan, Jill Sommerset, Manar Khashram

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Rest pain, ulceration and gangrene are hallmark features of chronic limb-threatening ischaemia (CLTI). Wound healing can be challenging, and this is compounded by an inability to measure lower limb perfusion via non-invasive tools such as toe pressure (TP). Novel perfusion tests, such as pedal acceleration time (PAT), may overcome some limitations. This study aimed to quantify the proportion of patients with CLTI that were unable to undergo TP measurement. Over a three-year duration, 344 consecutive patients with CLTI underwent PAT assessment (403 limbs). Overall, 32% of limbs were unable to undergo first toe TP, and 12.9% were unable to undergo first and second toe TP due to forefoot/digit amputation or tissue loss. Inability to measure first toe TP disproportionately impacted CLTI patients with diabetes compared to patients without diabetes (39.6% limbs (106/268); vs. 17% limbs (23/135); p < 0.001). Novel modalities may provide a useful tool for assessing perfusion in CLTI.

Original languageEnglish
Pages (from-to)779-782
Number of pages4
JournalWound Repair and Regeneration
Volume31
Issue number6
DOIs
Publication statusPublished - 1 Nov 2023

Keywords

  • chronic limb-threatening ischaemia
  • diabetic wound care
  • peripheral artery disease
  • wound
  • wound management

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