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CC BY-NC-ND 4.0 · Indian J Plast Surg 2013; 46(03): 508-512
DOI: 10.4103/0970-0358.121995
Original Article
Association of Plastic Surgeons of India

The effect of different positions on lower limbs skin perfusion pressure

Tota Kawasaki
Graduate School of Medicine, Faculty of Fukuoka Rehabilitation, International University of Health and Welfare, Kanagawa, Japan
,
Tetsuji Uemura
Departments of Plastic and Reconstructive Surgery, Kanagawa, Japan
,
Kiyomi Matsuo
Center of Comprehensive Community Medicine, Faculty of Medicine, Saga University, Saga, Kanagawa, Japan
,
Kazuyuki Masumoto
Departments of Plastic and Reconstructive Surgery, Kanagawa, Japan
,
Yoshimi Harada
Departments of Plastic and Reconstructive Surgery, Kanagawa, Japan
,
Takahiro Chuman
Departments of Plastic and Reconstructive Surgery, Kanagawa, Japan
,
Tomoyuki Murata
Kanagawa Rehabilitation Center, Kanagawa, Japan
› Author Affiliations
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Publication History

Publication Date:
07 October 2019 (online)

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ABSTRACT

We have encountered situations of patients with critical limb ischemia accompanied by pain at rest and necrosis, who hang their legs down from the bed during sleep. This lower limb position is known to be a natural position, which reduces pain in the lower extremity induced by ischemia. However, the effect of this position on blood flow of the lower extremity is poorly understood. We studied whether measurements of skin perfusion pressure (SPP) changes by leg position and the difference between healthy adults and patients with critical limb ischemia. The subjects of this study were 10 healthy adults and 11 patients with critical limb ischemia. Patients with critical limb ischemia, including both dorsum of foot and plantar of foot, having SPP of lower limbs of less than 40 mmHg (supine position) were the object of this study. SPP was measured on four positions (supine position, lower limbs elevation position, sitting position, and reclining bed elevation of 20° position). In sitting position, both the number of healthy adults and critical patients show significant increases in SPP compared with the other three positions. These results suggest that sitting position is effective to keep good blood stream of lower limbs not only in healthy adults but also in patients with critical limb ischemia. However, an appropriate leg position should not have lower limbs hang downwards for long periods time because edema is caused by the fall in venous return in lower limbs, and the wound healing is prolonged.

Our clinical research could be more useful in the future, particularly in developing countries, for surgeons managing wounds in leg and foot and preserving ischemic limbs.

KEY WORDS

Critical limb ischemia - peripheral arterial disease - position - skin perfusion pressure
 
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