Prospective use of xenon Xe 133 clearance for amputation level selection
W. S. Moore, R. E. Henry, J. M. Malone, M. J. Daly, D. Patton and S. J. Childers
Xenon Xe 133 clearance was used to select the most distal amputation level
that would allow sufficient blood flow for healing. Capillary blood flow
was first measured at the most distal potential amputation level, then at
successive proximal levels until an amputation site was found that had a
capillary skin blood flow rate greater than or equal to 2.6 mL/min/100 g of
tissue. Xenon Xe 133 in saline (100 to 500 mCi) was injected
intracutaneously at each level, and flow rates were determined using a
gamma camera interfaced with a computer system programmed for the
Ketty-Schmidt formula modified for capillary blood flow. There were 45
cases, including one toes, six transmetatarsal, five Syme's, 25 below-knee,
four knee disarticulation, three above-knee, and one hip disarticulation
amputation. All amputations in patients with flow rates exceeding 2.4
mL/min/100 g of tissue healed, with two exceptions.
