Predictive value of transcutaneous oxygen pressure and amputation success by use of supine and elevation measurements.
The purpose of this study was to determine if transcutaneous oxygen pressure (tcPO2) measurements can be used to predict amputation site healing in lower limbs with arterial occlusive disease. We measured tcPO2 (supine and with limb elevation) in 90 limbs before amputation and reviewed their subsequent clinical course. Of these, 52 (57%) successfully healed, 21 (23%) failed, and 17 (18%) exhibited delayed healing. Limbs with delayed healing or failure had significantly lower tcPO2 values than values of those that healed. A tcPO2 greater than or equal to 40 torr was associated with primary or delayed healing in 51 of 52 limbs (98%), and a tcPO2 value of less than 20 torr was universally associated with failure. For patients with a tcPO2 between 20 and 40 torr, tcPO2 measurements obtained during limb elevation improved the predictability of outcome. We conclude that supine tcPO2 measurements can help predict amputation site healing, and that tcPO2 measurement during limb elevation improves predictability in limbs with borderline supine tcPO2 values.
Bacharach
J M
JM
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905.
Rooke
T W
TW
Osmundson
P J
PJ
Gloviczki
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D001785:Blood Gas Monitoring, Transcutaneous; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011187:Posture; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D014945:Wound Healing