The Skin Temperature Guided Lower Limb Amputation

利用皮膚等溫線作為下肢截肢程度的指標

陳明庭(Ming-Ting Chen) ； 謝孟祥(Mon-Hsian Hsieh) ； 洪學義(Shyue-Yih Horng) ； 楊永健(Eng-Kean Yeong)

《中華民國重建整形外科醫學會雜誌》 5卷4期 (1996/12) Pp. 226-230

https://doi.org/10.7096/JPRSA.199612.0006

摘要

長久以來，對於下肢缺血性壞死的處置，其截肢高度的決定，一直是很困難的事情。但是，隨著復健觀念的演進，以及義肢製作技術的進步，以現代的觀點來看，截肢的部位已不需局限在“膝上(Above-knee, AK)”或“膝下(Below-knee, BK)”的層次。現在我們所需要的，是一種簡單，可靠的手術前評估方法，這種方法能夠儘可能的保留下肢的長度。在此我們利用溫度測量法，再加上31℃等溫線，做為此類截肢高度的指標。我們將之應用在臨床上，也得到不錯的結果。並且，手術時的組織發現和術前等溫線所預測的大致相同。因此，我們認為，此種利用等溫線做為截肢前高度預測的方法，不僅具有經濟、簡易、無侵犯性的優點，更對此類病人的術前評估，提供了另一種潛在發展的空間。

並列摘要

Amputation of lower limb has been a final conclusion of disaster for an intractable wound at distal end of the lower limb. The amputation procedure has been frequently taken place with wide varieties of different techniques. However in order to facilitate the efficacy of this procedure special attention has been employed to secure the good wound healing and to create durable amputated stump. In such repeated further amputation can be avoided and also early prosthesis fitting can be done to facilite the ambulaton of the patient. We utilize the surface skin temperature monitoring as a guide to decide the level of amputation. This is one of the most easy and noninvasive indicaton to judge the circulation. By experience, we define the isothermal line of 31℃ as a critical line of survival of tissue. And the amputated cut was done within the territory above the 31℃ isothermal zone. The design of flap at the amputated end also follow the situation of 31℃ isothermal line to modify. From Feb. 1995 to Nov. 1995. We had six lower limb ampulation guided with such skin temperature isothermal line and obtained excellent results on all stumps. We feel this is a easy and practical way to judge the level of ampulation.

並列關鍵字

amputation ； skin temperature monitoring ； thermometer ； isothermal zone line