Perioperative Changes in the Microcirculation in Feet After Foot and Ankle Surgery

The senior author (N.P.G.) observed that if the foot became dependent in the first 48 hours after foot surgery, the patient had swelling and pain. This effect seemed less after about 48 hours. The authors set out to see if there was a scientific basis for this. Laser Doppler was used to assess blood...

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Published inThe Journal of foot and ankle surgery Vol. 46; no. 4; pp. 238 - 241
Main Authors Attar, Fahad, MRCSEd, Selvan, Dave, MBChB, Machin, Dave, MBChB, Shariff, Raheel, MBBS, Geary, N.P., FRCS
Format Journal Article
LanguageEnglish
Published Baltimore, MD Elsevier Inc 01.07.2007
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Subjects
Adult
Aged
Ankle - surgery
Biological and medical sciences
Cardiovascular system
feet
Foot - blood supply
Foot - surgery
Humans
Investigative techniques, diagnostic techniques (general aspects)
laser Doppler flowmeter
Laser-Doppler Flowmetry
Medical sciences
Microcirculation
Middle Aged
Orthopedic surgery
Orthopedics
perioperative period
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Ultrasonic investigative techniques
feet
perioperative period
microcirculation
laser Doppler flowmeter
Sonography
Doppler ultrasound study
Microcirculation
Laser
Disease of the foot
Lower limb
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Summary:The senior author (N.P.G.) observed that if the foot became dependent in the first 48 hours after foot surgery, the patient had swelling and pain. This effect seemed less after about 48 hours. The authors set out to see if there was a scientific basis for this. Laser Doppler was used to assess blood flow in 14 patients. Flow was recorded in the big toe, at heart level, and on dependency, preoperatively and postoperatively. Postural vasoconstriction was calculated, and time for blood flow to normalize was recorded. Mean postural vasoconstriction preoperatively was 51.31%; postoperative mean at 24 hours was 23.05%, at 48 hours 36.62%, and at 72 hours 44.24%. There was a difference between the preoperative levels and the 24-, 48-, and 72-hour postoperative levels ( P < .05). Results showed that it takes longer than 72 hours rather than 48 hours for microcirculation to return to normal. The results emphasized the importance of postoperative foot elevation for at least 48 hours because of this phenomenon.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:1067-2516
1542-2224
DOI:10.1053/j.jfas.2007.03.003