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Teguh Marfen Djajakusumah
Padjadjaran University/Dr. Hasan Sadikin General Hospital, Indonesia
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Preoperative lactate, wound complications, and mortality following major amputation in patients with peripheral artery disease Teguh Marfen Djajakusumah; Indra Prasetya Yarman; Azis Satrio Wibowo
International Journal on Health and Medical Sciences Vol. 4 No. 3 (2026): August: Medical and Health Science
Publisher : Institute of Accounting Research and Novation (IARN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/healmed.v4i3.742

Abstract

Introduction: Peripheral Arterial Disease (PAD) is a leading cause of major lower-extremity amputation, particularly in patients with severe ischemia, gangrene, infection, or when revascularization is no longer feasible. Preoperative blood lactate is a biomarker reflecting tissue hypoperfusion and systemic metabolic stress, but its prognostic role in predicting postoperative wound complications and mortality after major amputation in PAD remains limited. Methods: This was an analytic observational study with a prospective cohort design conducted at Dr. Hasan Sadikin General Hospital between November 2024 and November 2025. Adult patients with PAD who underwent major amputation were enrolled using total sampling. Preoperative lactate levels were categorized into <2.5, 2.5–4, and >4 mmol/L, and associations with postoperative wound complications and mortality were analyzed using Fisher's Exact test. Results: A total of 51 patients met the study criteria; 60.8% were male and 52.9% were older than 60 years. Diabetes mellitus was the most common comorbidity (64.7%). Postoperative wound complications occurred in all patients with lactate >4 mmol/L, compared with 16 of 44 patients with lactate <2.5 mmol/L (p = 0.016). Mortality occurred in 4 of 5 patients with lactate >4 mmol/L, compared with 7 of 43 patients with lactate <2.5 mmol/L (p = 0.001). Discussion: Preoperative blood lactate is significantly associated with postoperative wound complications and mortality following major amputation in patients with PAD. Elevated lactate, particularly >4 mmol/L, identifies patients with worse postoperative outcomes, supporting its use as a simple, rapid, and accessible biomarker for perioperative risk stratification.
Correlation between smartphone thermographic temperature and visual infusion phlebitis score in surgical patients with peripheral intravenous access at Dr. Hasan Sadikin General Hospital Teguh Marfen Djajakusumah; Rani Septrina; Hiskia Pangeran
International Journal on Health and Medical Sciences Vol. 4 No. 3 (2026): August: Medical and Health Science
Publisher : Institute of Accounting Research and Novation (IARN)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/healmed.v4i3.744

Abstract

Phlebitis is a common complication of peripheral intravenous catheter use that increases patient morbidity and length of hospital stay. The Visual Infusion Phlebitis (VIP) score is widely used for clinical assessment but remains subjective and does not incorporate temperature as an inflammatory marker. Smartphone-based infrared thermography offers a potential objective, non-invasive, and practical adjunct parameter. This study aimed to determine the correlation between local temperature measured by smartphone thermography and VIP score in patients with peripheral intravenous access at Dr. Hasan Sadikin General Hospital. An observational analytic study with a cross-sectional design was conducted in 37 patients with catheter dwell time ≥72 hours. Temperature at the infusion site was measured using a smartphone-based thermal camera and compared with the contralateral healthy area, while phlebitis severity was simultaneously assessed using the VIP score. Data were analyzed using the Shapiro–Wilk normality test and Spearman correlation test at a 95% confidence level. The mean VIP score was 1.86 ± 1.38 (range 0–4), and the mean infusion-site temperature was 35.9 ± 1.7°C (range 33.2–38.1°C). A statistically significant, moderate positive correlation was found between VIP score and thermographic temperature (r = 0.52; p = 0.002), indicating that higher VIP scores were associated with increased local temperature, reflecting the underlying inflammatory process. These findings suggest that smartphone-based thermographic imaging may serve as a useful objective adjunct in phlebitis evaluation among patients with peripheral intravenous access, complementing rather than replacing comprehensive clinical assessment.
Co-Authors Azis Satrio Wibowo Hiskia Pangeran Indra Prasetya Yarman Rani Septrina