Comparison of transcutaneous oximetry and laser Doppler flowmetry as noninvasive predictors of wound healing after excision of extremity soft-tissue sarcomas.
BACKGROUND
We wished to determine whether transcutaneous oximetry or laser Doppler flowmetry (LDF) could identify patients at risk for wound failure after conservative, limb-sparing surgery for extremity sarcomas.


METHODS
Studies were performed on postoperative days (PODs) 1, 4/5, 7, and 9. Measurements of transcutaneous oxygen pressure (tcPO2) were taken at breathing room air (BL) and 100% oxygen (rate tcPO2). LDF measurements were taken at multiple sites along the wound, and a perfusion index was calculated.


RESULTS
Twenty-four patients were studied. Four (17%) had nonhealing wounds. There was no difference in tcPO2 (BL) values between healed and nonhealing wounds. Measurement of rate tcPO2 on POD 1 was significantly lower in the nonhealing wounds than in those with normal healing (28.5 +/- 12.1 mm Hg vs 14.3 +/- 16.2 mm Hg, mean +/- SD, p = 0.03). Rate tcPO2 values increased significantly in healing wounds from POD 1 to PODs 7 and 9 (p = 0.006, p = 0.009). This increase was absent in nonhealing wounds. A clear separation was noted in rate tcPO2 values between groups, with a minimum rate tcPO2 value recorded in a healed wound of 9 mm Hg/min, compared with the maximum value in a nonhealing wound of 7 mm Hg/min. The LDF perfusion index failed to predict wound healing at any of the measured time points.


CONCLUSIONS
This study showed that measurement of tcPO2 during oxygen inhalation can accurately predict wound healing in patients after excision of an extremity sarcoma.
Conlon
K C
KC
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Sclafani
L
L
DiResta
G R
GR
Brennan
M F
MF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001785:Blood Gas Monitoring, Transcutaneous; D001918:Brachytherapy; D005121:Extremities / Q000601:surgery*; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage; D007511:Ischemia / Q000175:diagnosis; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D010102:Oxygen Inhalation Therapy; D010313:Partial Pressure; D011237:Predictive Value of Tests; D011379:Prognosis; D012509:Sarcoma / Q000532:radiotherapy / Q000601:surgery*; D012867:Skin / Q000098:blood supply; D013529:Surgical Wound Dehiscence / Q000175:diagnosis*; D014945:Wound Healing / Q000502:physiology*
D007496:Iridium Radioisotopes; D010100:Oxygen