Local blood flow, pressure and resistance measured with a strain gauge plethysmograph in limbs with constricting burns before and following treatment with incisional decompression

Abstract

The effect of decompression incisions on the local blood flow, pressure and resistance was examined with a strain gauge plethysmograph and venous occlusion in 7 patients. The measurements were performed immediately before and following incisional decompression. The treatment was instituted on well accepted clinical indications, and the results of the measurements were not available for the surgeons before the project was completed. The strain gauge plethysmograph was found helpful as a supplement to the clinical evaluation of the indications for incisional decompression. In 24 of the 28 burned fingers or legs of the 7 patients, the blood flow was insufficient or low before incisional decompression, but rose significantly following the treatment, supporting its causal effect. The remaining 4—all burned fingers from 3 different patients—had a high blood flow initially and would probably not have been incised if the results had been available at that time. The surgeons considered all fingers on the same hand to be burned to the same degree. An estimate of the local vascular resistance in 19 limbs confirmed the conclusion based on the blood flows. The data obtained also confirmed the generally accepted hypothesis of the pathogenesis of hypoxic fibrosis and necrosis in constricting limb burns.