Document Detail


Assessment of tissue viability in complex extremity injuries: utility of the pyrophosphate nuclear scan.
MedLine Citation:
PMID:  11242290     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Extensive extremity injuries often require difficult decisions regarding the necessity for amputation or radical debridement. During the past decade, we have used technetium-99 pyrophosphate (PyP) scanning as an adjunct in this setting. This study was performed to assess the accuracy of PyP scan in predicting the need for amputation in relation to clinical, operative, and pathologic findings. METHODS: Review of our computerized registry identified 11 patients (10 men, age 36.1 +/- 14.9 years) admitted from 1990 to 1999 who underwent PyP scan. Using operative and pathologic findings, accuracy of the PyP scan was graded as supporting or refuting the clinical assessment of the need for amputation. RESULTS: Eight patients suffered high-voltage electrical injuries, one had severe frostbite, and two suffered soft-tissue infections. In most cases, PyP scan showed clear demarcation of viable and nonviable tissue, verifying the need for amputation (positive); those that demonstrated viable distal tissues confirmed at operation were considered negative. PyP scan had a sensitivity of 94%, a specificity of 100%, and an accuracy of 96% in this setting. CONCLUSION: Technetium-99 PyP scanning is a useful adjunct in predicting the need for amputation in extremities damaged by electrical injury, frostbite, or invasive infection. In addition, by providing an objective "picture" of extremity perfusion, PyP scans can be helpful in convincing patients of the need for amputation.
Authors:
D G Affleck; L Edelman; S E Morris; J R Saffle
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  50     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-03-12     Completed Date:  2001-04-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  263-9     Citation Subset:  AIM; IM    
Affiliation:
University of Utah Department of Surgery, School of Medicine, 50 North Medical Drive, Salt Lake City, UT 84132, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Amputation*
Arm
Burns / pathology*,  surgery
Burns, Electric / pathology,  surgery
Cell Survival
Child
Female
Humans
Leg
Male
Middle Aged
Radiopharmaceuticals / diagnostic use*
Soft Tissue Infections / pathology*,  surgery
Technetium Tc 99m Pyrophosphate / diagnostic use*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Technetium Tc 99m Pyrophosphate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Mild hypothermia increases survival from severe pressure-controlled hemorrhagic shock in rats.
Next Document:  The importance of gender on outcome after major trauma: functional and psychologic outcomes in women...