A retrospective review of wounds in the lower limbs was carried out to examine the association between skin perfusion pressure and closure time of wounds. A total of 1125 wounds in 998 patients presenting to the wound clinic between June 2006 and October 2014 were assessed. A laser Doppler instrument was used to measure the skin perfusion pressure. The number of patients with diabetes was 426; 879 patients were aged ≥65 years and 552 patients were women. Skin perfusion pressure is a simple and reliable tool to diagnose peripheral arterial disease (PAD). Based on the values obtained, the skin perfusion pressure was categorised into three: ≤30 mmHg, 31-50 mmHg and >50mmHg, indicative of severe PAD and critical limb ischemia, mild and moderate PAD and patients with no PAD, respectively. 

Wounds with higher skin perfusion pressures were found to have shorter wound closure times (p < 0.0010). The average wound closure time for each of the 3 groups of 235 days, 98 days and 52 days, respectively. Wound healing was longer in patients with diabetes compared to non-diabetics, although a non significant difference between the skin perfusion pressure values was observed between patients with diabetes and those without diabetes; 63.7 mmHg and 62.1 mmHg, respectively (p > 0.05). No association between wound closure time and age and gender was observed. Diabetic patients take more time to achieve wound closure at any given value of skin perfusion pressure in comparison to non-diabetic patients.  

According to the study, measurement of the skin perfusion pressure is a useful indicator of time to wound closure. It can predict how long the wound would take to heal as well as the need for any vascular interventions in lower extremity wounds.  Despite a rushed vascular intervention, wound with skin perfusion pressure ≤30 mmHg will take longer to health.

Suzuki K, et al.  J Am Coll Clin Wound Spec. 2018 Oct 9;9(1-3):14-18.