title: The use of hemoglobin saturation ratio as a means of measuring tissue perfusion in the development of heel pressure sores.
abstract: The heel is a common site of pressure ulcers. The amount of pressure and time needed to develop these wounds is dependent on various factors including pressure surface, the patient's anatomy, and co-morbidities. We studied the use of the hemoglobin saturation ratio as a means of assessing heel perfusion in various pressure settings. The mixed perfusion ratio in the heels of 5 volunteers was assessed on 3 pressure surfaces and at the time of off-load. The surfaces studied included: stretcher pad, plastic backboard without padding, and pressure reduction gel. Each surface was measured for 5 minutes with a real-time reading. On the stretcher, the average StO2% decrease for each pressure surface was 26.2 ± 10 (range 18-43). The average StO2% decrease on the backboard was 22.8 ± 12.3 (range 8-37), and 24.0 ± 4.8 (range 19-30) on the gel pad. The StO2% drop plateaued with the stretcher and gel pad, but with the backboard there was a continued slow drop at 5 minutes. This study demonstrates that hemoglobin oxygenation ratio may be effective in assessing a tissue's direct perfusion in the setting of tissue pressure and may also be beneficial to better assess the effects of pressure-reduction surfaces. Further studies will be needed to determine time to skin breakdown as it pertains to pressure and tissue oxygenation.
authors.affiliation: Long Island Plastic Surgical Group Garden City, New York.
authors.forename: Kristen A
authors.initials: KA
authors.lastname: Aliano
authors.affiliation: Long Island Plastic Surgical Group Garden City, New York.
authors.forename: Steve
authors.initials: S
authors.lastname: Stavrides
authors.affiliation: Long Island Plastic Surgical Group Garden City, New York.
authors.forename: Thomas
authors.initials: T
authors.lastname: Davenport
mesh_terms: D001783:Blood Flow Velocity; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006365:Heel / Q000503:physiopathology*; D006454:Hemoglobins / Q000032:analysis*; D006455:Hemoglobins, Abnormal; D006801:Humans; D008297:Male; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D003668:Pressure Ulcer / Q000175:diagnosis* / Q000503:physiopathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D006455:Hemoglobins, Abnormal; C046189:hemoglobin Savaria; D010100:Oxygen