title: Can macrocirculation changes predict nonhealing diabetic foot ulcers?
abstract: OBJECTIVE
  Transcutaneous partial oxygen tension (TcpO2) is considered the gold standard for assessment of tissue oxygenation, which is an essential factor for wound healing. The purpose of this study was to evaluate the association between macrocirculation and TcpO2 in persons with diabetes mellitus.
  
  
  METHODS
  Ninety-eight patients with diabetic foot ulcers participated in the study (61 men and 37 women). The subjects had a mean age of 66.6 years (range, 30-83 years) and were treated at the Diabetic Wound Center of Korea University Guro Hospital, Seoul, Republic of Korea.
  
  
  METHODS
  Macrocirculation was evaluated using 2 techniques: computed tomographic angiography and Doppler ultrasound. Macrocirculation scores were based on the patency of the two tibial arteries in 98 patients. Computed tomographic angiography and Doppler ultrasound scores (0-4 points) were given according to intraluminal filling defects and arterial pulse waveform of each vessel, respectively. Tissue oxygenation was measured by TcpO2. Macrocirculation scores were statistically analyzed as a function of the TcpO2.
  
  
  RESULTS
  Statistical analysis revealed no significant linear trend between the macrocirculation status and TcpO2. Biavariate analysis using the Fisher exact test, Mantel-Haenszel tests, and McNemar-Bowker tests also found no significant relationship between macrocirculation and TcpO2.
  
  
  CONCLUSIONS
  Computed tomographic angiography and Doppler ultrasound are not sufficiently reliable substitutes for TcpO2 measurements in regard to determining the optimal treatment for diabetic patients.
authors.affiliation: Ye-Na Lee, RN, CWCN, Diabetic Wound Center, Korea University Guro Hospital, Seoul, Korea. Hyon-Surk Kim, MD, Clinical Instructor, Department of Plastic Surgery, University Anam Hospital, Seoul, Korea. Jeong-A Kang, RN, Diabetic Wound Center, Korea University Guro Hospital, Seoul, Korea. Seung-Kyu Han, MD, PhD, Professor, Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Ye-Na
authors.initials: YN
authors.lastname: Lee
authors.forename: Hyon-Surk
authors.initials: HS
authors.lastname: Kim
authors.forename: Jeong-A
authors.initials: JA
authors.lastname: Kang
authors.forename: Seung-Kyu
authors.initials: SK
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001785:Blood Gas Monitoring, Transcutaneous / Q000379:methods* / Q000592:standards; D017719:Diabetic Foot / Q000150:complications / Q000401:mortality* / Q000628:therapy; D005260:Female; D005528:Foot / Q000098:blood supply* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D014022:Tissue Survival / Q000502:physiology*; D014945:Wound Healing / Q000502:physiology*