Effect of body position on skin perfusion pressure in patients with severe peripheral arterial disease

Abstract

Background: Skin perfusion pressure (SPP) has been shown to be useful in the assessment of the severity of peripheral arterial disease (PAD), and ulcers can be cured when the SPP is >30-40mmHg. The purpose of this study was to determine the best body position for measuring SPP in patients with severe PAD. Methods and Results: We studied 24 limbs of 18 patients with PAD whose SPP was <40mmHg. After patients had been resting supine for 10 min (Position I), their SPP was measured at the dorsum of the foot with a laser Doppler probe. Following measurement in the supine position, SPP was measured in the sitting position after the foot had been extended horizontally for 10 min (Position II), and in the sitting position after the foot had been lowered vertically for 10min (Position III). SPP increased significantly from Position I to Positions II and III (25.3±10.9mmHg, 40.6±12.7mmHg, and 73.4±17.7mmHg, respectively; P<0.0001). In all patients, SPP values exceeding 30mmHg were obtained in Position III. Conclusions: The best SPP values were obtained in Position III, which is the ideal position for peripheral arterial circulation in patients with severe PAD.