Elective foot surgery in limbs with arterial disease.

Surgical correction of foot deformities is generally indicated to relieve the disability. The presence or suspicion of arterial disease may lead to the reluctance to operate because of the concern that healing might not occur, however. Twenty-three patients were referred for vascular assessment before elective foot surgery. There was little or no evidence of arterial disease in 15 limbs. In eight limbs there was unequivocal evidence of complete obstruction in the main limb artery. Contrary to what might be expected, healing after surgery occurred without difficulties in the limbs with arterial obstruction. The arterial disease as assessed by laboratory methods was not severe. The results indicate that elective foot surgery can be safely undertaken in some limbs. Simple laboratory methods for assessment of arterial circulation include measurements of distal blood pressure, skin temperature, transcutaneous oxygen tension, and assessment of digital pulsatility. A useful approach for estimating the chances of healing after elective surgery in limbs with arterial obstruction is formulated on the basis of the clinical and laboratory assessment.