Skin blood flow level and stump healing in ischemic amputations

Skin blood flow was measured with xenon 133-histamine mixture in 20 lower extremities of 18 patients before performing amputations. The amputation levels were chosen according to clinical criteria; 13 below-knee, 3 distal femoral, 1 midfemoral, 2 transmetatarsal, and 1 Syme's amputations were performed. Fourteen stumps had normal healing, 2 had delayed healing, and 3 had necrosis. All of the stumps with normal healing had a skin blood flow >1.76 ml/100 g tissue/minute. Bleeding from the skin also was a good predictor of healing. Skin blood flow measurement may be helpful for level selection in ischemic amputations.