Predictive value of routine transcutaneous tissue oxygen tension (tcpO2) measurement for the risk of non-healing and amputation in diabetic foot ulcer patients with non-palpable pedal pulses.
BACKGROUND
It was evaluated whether transcutaneous tissue oxygen tension (tcpO2) measurement, when assessed in daily routine, can be used to predict the risk of non-healing and amputation in diabetic foot ulcer patients with non-palpable pedal pulses.


METHODS
Patients were followed up in an outpatient setting according to a comprehensive wound-care protocol. tcpO2 measurements were performed at the dorsum of the forefoot in a standardized setting. Patients were divided into three subgroups according to their initial tcpO2-readings (tcpO2 <20 mmHg, tcpO2 20-40 mmHg, tcpO2 >40 mmHg). Patients with clinical signs of soft tissue infection at the initial presentation were excluded.


RESULTS
One hundred forty-one patients were enrolled. Wounds associated with a tcpO2 reading <20 mmHg demonstrated a significantly decreased probability of healing compared with those associated with a tcpO2 >40 mmHg (p=0.008). In addition, the risks of soft tissue infection (p=0.057) and hospitalization during follow-up (p=0.019) were different among the three groups. The overall amputation rate increased with decreasing tcpO2 (p=0.014) although there was no significant difference for major amputations (p=0.448).


CONCLUSIONS
Routine assessment of tcpO2 is suitable as a clinical screening tool for estimating the risk of non-healing in diabetic foot ulcer patients without palpable pedal pulses. However, its predictive value for the risk of amputation remains unclear.
Ladurner
Ruth
R
Department of General and Transplant Surgery, University Hospital of Tübingen, Germany. ruth.ladurner@med.uni-tuebingen.de
Küper
Markus
M
Königsrainer
Ingmar
I
Löb
Stefan
S
Wichmann
Dörte
D
Königsrainer
Alfred
A
Coerper
Stephan
S
Beckert
Stefan
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D017719:Diabetic Foot / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D012306:Risk; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
D010100:Oxygen