Clinical Analysis of Chronic Ischemic Foot Ulcer using Ischemic Index with Flowmeter and Wagner Classification.

Oh, Myung Rok; Lee, Nae Ho; Yang, Kyung Moo

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1999;26(4):635-640.
Published online July 1, 1999.

Clinical Analysis of Chronic Ischemic Foot Ulcer using Ischemic Index with Flowmeter and Wagner Classification.

Myung Rok Oh, Nae Ho Lee, Kyung Moo Yang

Abstract

It is currently necessary to manage chronic ischemic foot gangrene because the rate of hospitalization and operations is increasing as a result of diet change and the growth of an aging population. Chronic ischemic foot gangrene is caused by Buerger`s disease, atherosclerosis and particularly, diabetes. In this study, we used the Wagner ischemic index with Doppler flowmeter and Wagner classification on 62 patients over 8 years from 1991 to 1998 as an index for treatment and prognosis. We measured the systolic pressure to determine the ischemic index, and according to Wagner the blood flow was inadequate in cases of diabetic foot gangrene and nondiabetic foot gangrene when it was below 0.45 and 0.35, respectively. According to the observation of clinical symptoms, we divided the cases by Wagner classification. Based on the above data, we performed conservative treatment, skin graft, local flap, superficial sural arterial island flap and amputation. We then followed up the patients and observed the treatment results. We concluded that the Wagner ischemic index with Doppler flowmeter and Wagner classification was useful in determining, selecting, and predicting the rate of survival or death as a result of amputation and graft when a surgical operation is performed.