Photoplethysmographic selection of amputation level in peripheral vascular disease

In a prospective study 37 patients who required amputations of the leg were studied with a new technique: segmental photoplethysmographic skin perfusion pressures. The decision to amputate was made by a vascular surgeon in a traditional manner, with the aid of clinical criteria. The simple method of determining skin perfusion pressures with photoplethysmography is described; 273 measurements were performed. The technique proved to be highly correlated (r = 0.88) with wound healing after amputation, at a separating value of 21 mm Hg (p = 0.0001). The study suggests that the value of this noninvasive method will be to enable the surgeon to amputate at a lower level and to diminish complications and failure of rehabilitation.