The clinical value of preoperative indirect systolic ankle pressure measurements in wound healing after amputation of the lower extremity.

With the intention towards more distal amputation of the lower extremity for peripheral vascular disease, failure of amputation wound healing remains a common clinical problem. Because calf blood flow correlates well with the indirect systolic ankle pressure, this pressure could be a prognostic guide to the outcome of amputation wound healing. To evaluate the clinical role of systolic ankle pressure measurements for selecting the most appropriate level of amputation, data of 93 patients undergoing 100 amputations were studied retrospectively. Of the 54 initial below knee (BK) amputations 83% healed and 17% failed to heal. Of the 46 initial above knee (AK) amputations 88% healed and 12% needed stump correction. Although all extremities with a systolic ankle pressure of more than 70 mm Hg healed in BK amputations there was no clinical predictive value of indirect systolic ankle pressure measurements. There was no difference in wound healing between diabetic and non-diabetic patients.