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Titre du document / Document title

Assessment of tissue viability in complex extremity injuries : Utility of the pyrophosphate nuclear scan

Auteur(s) / Author(s)

AFFLECK David G. (1) ; EDELMAN Linda (1) ; MORRIS Steven E. (1) ; SAFFLE Jeffrey R. (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) University of Utah Department of Surgery, School of Medicine, Salt Lake City, Utah, ETATS-UNIS

Résumé / Abstract

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.

Revue / Journal Title

The Journal of trauma, injury, infection, and critical care    ISSN  1079-6061 

Source / Source

Congrès
Annual Meeting of the Western Trauma Association No30, Squaw Valley, California , ETATS-UNIS (27/02/2000)
2001, vol. 50, no2, pp. 263-269 (10 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1995) (Revue)

Mots-clés anglais / English Keywords

Frostbite

;

Electrical burn

;

Complication

;

Infection

;

Skin

;

Soft tissue

;

Viability

;

Technique

;

Diagnosis

;

Scintigraphy

;

Diphosphates

;

Human

;

Skin disease

;

Trauma

;

Cold induced disorder

;

Radionuclide study

;

Mots-clés français / French Keywords

Gelure

;

Brûlure électrique

;

Complication

;

Infection

;

Peau

;

Partie molle

;

Viabilité

;

Technique

;

Diagnostic

;

Scintigraphie

;

Diphosphate

;

Homme

;

Peau pathologie

;

Traumatisme

;

Trouble dû au froid

;

Exploration radioisotopique

;

Mots-clés espagnols / Spanish Keywords

Heladura

;

Quemadura eléctrica

;

Complicación

;

Infección

;

Piel

;

Parte blanda

;

Viabilidad

;

Técnica

;

Diagnóstico

;

Centelleografía

;

Difosfato

;

Hombre

;

Piel patología

;

Traumatismo

;

Trastorno por frío

;

Exploración radioisotópica

;

Localisation / Location

INIST-CNRS, Cote INIST : 507, 35400009870198.0110

Nº notice refdoc (ud4) : 929317



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