Effects of Intermittent Pneumatic Compression on Reduction of Postoperative Lower Extremity Edema and Normalization of Foot Microcirculation Flow in Patients Undergoing Arterial Revascularization
Katarzyna Pawlaczyk, Marcin Gabriel, Tomasz Urbanek, Łukasz Dzieciuchowicz, Zbigniew Krasiński, Zofia Gabriel, Małgorzata Olejniczak-Nowakowska, Michał Stanisić
Department of Hypertensiology, Angiology and Internal Diseases, Medical University, Poznań, Poland
Med Sci Monit 2015; 21:3986-3992
In patients with chronic leg ischemia, the beneficial effect of arterial revascularization can be significantly decreased due to postoperative leg swelling. The aim of this study was to assess the effects of intermittent pneumatic compression (IPC) on skin flow normalization in patients undergoing revascularization procedures due to chronic leg ischemia.
MATERIAL AND METHODS: We evaluated 116 patients with chronic leg ischemia. The patients were divided into groups according to the performed treatment (endovascular or surgical) and implementation of IPC postoperatively. The leg edema assessment and microcirculation flow assessment were performed pre- and postoperatively, using percutaneous O2 pressure (TcpO2), cutaneous blood perfusion (CBP) measurements, and skin flow motion assessment.
RESULTS: In patients who did not receive IPC, a decrease in CBP value was observed in the 1st postoperative assessment. Among patients receiving IPC, the CBD value increased at the 1st and 2nd postoperative measurements, especially in the surgical group. The lowest TcpO2 values were observed in by-pass surgery group without IPC postoperatively.
CONCLUSIONS: The benefits of the by-pass procedure in patients with leg ischemia can be significantly reduced by postoperative edema. Among patients with postoperative leg edema, local tissue blood perfusion can be improved by the use of IPC, which can result in decreased local leg swelling, as well as improved skin blood perfusion and TcpO2.
Keywords: Foot - blood supply, Edema - therapy, Arteries - surgery, Intermittent Pneumatic Compression Devices, Leg - blood supply, Microcirculation