Ischaemic wound complications in above-knee amputations in relation to the skin perfusion pressure

Healing of the stumps in 59 above-knee amputations was correlated with the local skin perfusion pressure (SPP) measured preoperatively as the external pressure required to stop isotope washout using 131I-(-) or 125I-(-) antipyrine mixed with histamine. Out of the 11 cases with an SPP below 30 mmHg no fewer than 9 (82 per cent) suffered wound complications. Out of the 48 cases with an SPP above 30 mmHg severe wound complications occurred in only 4 cases (8 per cent). The difference in wound complication rate is highly significant (P < 0.01). It is concluded that the SPP can be used to predict ischaemic wound complications in above-knee amputations as has previously been shown to be the case in below-knee amputations.