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Skin perfusion pressure — SPP

SPP is a noninvasive method that leverages laser Doppler to measure blood perfusion in the microcirculation. It is primarily used in clinical (and clinical research) settings to assess wound healing potential — especially in patients with chronic conditions such as diabetic foot [1].

One of the main advantages of SPP is that it is not affected by vascular calcification or anatomical structure. When clinical conditions — such as wounds on the sole or amputated toes — preclude the application of toe pressure or TcpO2, SPP is a viable alternative.

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periflux 6000 SPP-probe foot plantar

SPP with PeriFlux 6000

It’s possible to carry out toe pressure and SPP in a single patient visit.

periflux 6000 combined system skin perfusion pressure setup

SPP can be measured at multiple sites: on the foot (plantar, dorsal, and toes), on the ankle, and above and below the knee. Blood flow is occluded by placing a pressure cuff over the probe and inflating it above the patient’s resting systolic pressure. The cuff is then gradually deflated until microcirculatory flow returns — this is the SPP value and is measured in millimeters of mercury (mmHg).

SPP can help identify ischemic areas (by, for example, using the angiosome concept). Comparing SPP measurements in areas adjacent to a non-healing ulcer can reveal microcirculatory vascular deficiencies.

When to use SPP

Not all patients are the same, toe pressure, for example, isn’t feasible for a person whose toes have been amputated. For patients with edema, callouses, or wounds on the sole or plantar region, SPP is the most applicable means for measuring the microcirculation.

Interpreting SPP results

The 2023 update of the IWGDF guidelines [2], includes SPP values for wound-healing prognosis, stating that values ≥ 40 mmHg can increase the probability of healing by up to 30%.

The main advantage of SPP is that it is not affected by vascular calcification and anatomical structure. [3]

Related products and applications

PeriFlux 6000
Combined System
product-type

PeriFlux 6000
Combined System

A powerful, all-in-one vascular care solution designed to deliver comprehensive macro- and microvascular measurements primarily for clinical use.
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Combined System
PeriFlux 6000 Pressure System
product-type

PeriFlux 6000 Pressure System

For clinical/research practice focusing on pressure exams like TBI, ABI, SPP, and segmental pressure.
Show product Arrow right about PeriFlux 6000 Pressure System
Laser Doppler Probe 404-NI
product-type

Laser Doppler Probe 404-NI

A low-profile laser Doppler probe designed for noninvasive measurement of blood perfusion such as SPP.
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Wound healing
application_cat Clinical and Clinical research
Clinical and Clinical research

Wound healing

Conditions like diabetes and PAD affect healing potential as they lower the level of essential oxygen and nutrients at the wound site.
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Diabetic foot
application_cat Clinical and Clinical research
Clinical and Clinical research

Diabetic foot

A serious and painful condition that is more prevalent in people with diabetes and can lead to amputation.
Read more Arrow right about Diabetic foot

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References

  1. Gornik, H. L., Aronow, H. D., Goodney, P. P., Arya, S., Brewster, L. P., Byrd, L., Chandra, V., Drachman, D. E., Eaves, J. M., Ehrman, J. K., Evans, J. N., Getchius, T. S. D., Gutiérrez, J. A., Hawkins, B. M., Hess, C. N., Ho, K. J., Jones, W. S., Kim, E. S. H., Kinlay, S., Kirksey, L., … Wilkins, L. R. (2024). 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation, 149(24), e1313–e1410. https://doi.org/10.1161/CIR.0000000000001251
  2. International Working Group on the Diabetic Foot (IWGDF). Guidelines on the prevention and management of diabetic foot disease (2023 update). https://iwgdfguidelines.org
  3. Pan, X., Chen, G., Wu, P., Han, C., & Ho, J.K. (2018). Skin perfusion pressure as a predictor of ischemic wound healing potential (Review). Biomedical Reports, 8, 330-334. https://doi.org/10.3892/br.2018.1064