Skin perfusion pressure in the prediction of healing in diabetic patients with ulcers or gangrene of the foot.

The measurement of skin perfusion blood pressure (SPP) estimated by an isotope clearance technique has been used to predict the healing of ulcers or gangrene of the foot in 61 diabetic subjects. Healing followed conservative treatment or local surgery in 1 of 21 cases if the SPP was less than 40 mm Hg but in 35 of 40 with higher values for SPP. Healing was unlikely if the toe blood pressure was less than 40 mm Hg or the ankle systolic pressure was less than 80 mm Hg. It is recommended that the SPP be measured in patients in whom confident predictions of healing cannot be made on the basis of ankle pressure or other measurements.