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Titre du Document
Assessment of tissue viability in complex extremity injuries : Utility of the pyrophosphate nuclear scan
AFFLECK David G. ; EDELMAN Linda ; MORRIS Steven E. ; ...
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.
Lippincott Williams & Wilkins
Type du document
Conférence : Annual Meeting of the Western Trauma Association, 30, Squaw Valley, California, USA, 2000-02-27
PMID : 11242290 ISSN : 1079-6061
The Journal of trauma, injury, infection, and critical care A. 2001, vol. 50, n° 2, pp. 263-269 [bibl. : 10 ref.]
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