A simplified evaluation of vital capillary microscopy for predicting skin viability in patients with severe arterial insufficiency
- 1 October 1984
- journal article
- research article
- Published by Wiley in Clinical Physiology and Functional Imaging
- Vol. 4 (5), 403-411
- https://doi.org/10.1111/j.1475-097x.1984.tb00125.x
Abstract
Summary. In the present study the predictive value of a simplified VCM (Vital Capillary Microscopy) classification in assessing the development of skin necrosis was investigated in 69 patients with severe peripheral arterial obliterative disease (AOD) of the leg. The arterial circulation of the foot was evaluated by systolic blood pressure (SBP,). The structure and blood filling of the skin capillaries of all toes and forefeet were evaluated by an ordinary stereo-microscope at a magnification of 10 to 40 times. A three stage classification was used for evaluating the nutritive skin capillaries: Stage A, B and C. The individual patient was classified according to the worst stage found in the foot. The predictive value for the SBP, measurements with regard to the development of skin necrosis was for the best group (21–30 mmHg) 6%, for the middle group (11–20 mmHg) 58% and for the worst group (0–10 mmHg) 56%. The predictive values for the VCM Stages A, B and C were 5, 16 and 93% respectively. The sensitivity with the borderline between Stage A and B + C was 97% and the specificity 53%. With the borderline between Stage A + B and C the sensitivity and specificity became 87% and 95% respectively. It may be concluded that the VCM classification with three stages used in the present study seems to be very useful for predicting the risk of skin necrosis in patients with severe AOD.This publication has 8 references indexed in Scilit:
- Estimation of digital circulation and its correlation to clinical signs of ischaemia‐a comparative methodological studyClinical Physiology and Functional Imaging, 1983
- Gangrene of the Toes with Palpable Peripheral Pulses. Response to Platelet Suppressive TherapyAnnals of Surgery, 1981
- Transcutaneous Oxygen Tension in Imminent Foot GangreneActa Anaesthesiologica Scandinavica, 1978
- The skin microcirculation and the pathogenesis of ischaemic necrosis and gangreneScandinavian Journal of Clinical and Laboratory Investigation, 1977
- Digital Blood Pressure in Normal Subjects and Patients with Peripheral Arterial Disease Effect of Change in TemperatureScandinavian Journal of Clinical and Laboratory Investigation, 1976
- Blood Flow Characteristics and Tissue Nutrition in Apparently Ischaemic FeetBMJ, 1971
- Digital Systolic Pressures in the Lower Limb in Arterial DiseaseCirculation, 1971
- Abnormalities of the Digital Vasculature as Related to Ulceration and GangreneCirculation, 1968