Abstract
We have performed modified transmetatarsal amputation (modified TMA) which preserves perforators around metatarsal bones to prevent soft tissues necrosis. In some cases, declines in blood flow to soft tissues and necrosis couldn’t avoid, nevertheless modified TMA was performed. In order to examine the causes of declines of blood flow to peripheral tissues, we researched 11 patients’ changes of skin perfusion pressure (SPP) before and after modified TMA. All patients were operated revascularization procedure before TMA. 3 patients’ both dorsal and plantar SPP rose. 3 patients’ both dorsal and plantar SPP decreased and their wound healings were protracted. 4 patients’ either side SPP decreased on the other side SPP rose and 2 of their wound healings were protracted. Revascularized arteries were obstructed on 3 patients whose both side SPP decreased. Perforator occlusion will be responsible for either side SPP decreasing. Modified TMA has high rate of wound healing. But it has a possibility that leads to soft tissue necrosis because of perforator occlusion. How to prevent perforator occlusion is our future consideration.
