title: Evaluation of peripheral microcirculation improvement of foot after tarsal tunnel release in diabetic patients by transcutaneous oximetry.
abstract: BACKGROUND
  According to recent studies, peripheral nerve decompression in diabetic patients seems to not only improve nerve function, but also to increase microcirculation; thus decreasing the incidence of diabetic foot wounds and amputations. However, while the postoperative improvement of nerve function is demonstrated, the changes in peripheral microcirculation have not been demonstrated yet. The aim of this study is to assess the degree of microcirculation improvement of foot after the tarsal tunnel release in the diabetic patients by using transcutaneous oximetry.
  
  
  METHODS
  Twenty diabetic male patients aged between 43 and 72 years old (mean age 61.2 years old) suffering from diabetic peripheral neuropathy with superimposed nerve compression underwent transcutaneous oximetry (PtcO2) before and after tarsal tunnel release by placing an electrode on the skin at the level of the dorsum of the foot. Eight lower extremities presented diabetic foot wound preoperatively. Thirty-six lower extremities underwent surgical release of the tibialis posterior nerve only, whereas four lower extremities underwent the combined release of common peroneal nerve, anterior tibialis nerve, and posterior tibialis nerve.
  
  
  RESULTS
  Preoperative values of transcutaneous oximetry were below the critical threshold, that is, lower than 40 mmHg (29.1 ± 5.4 mmHg). PtcO2 values at one month after surgery (45.8 ± 6.4 mmHg) were significantly higher than the preoperative ones (P = 0.01).
  
  
  CONCLUSIONS
  The results of postoperative increase in PtcO2 values demonstrate that the release of the tarsal tunnel determines a relevant increase in microcirculation in the feet of diabetic patients.
authors: Department of Plastic and Reconstructive Surgery, University of Sassari, Sassari, Italy.|Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Emilio
authors: E
authors: Trignano
authors: Department of Plastic and Reconstructive Surgery, "Sapienza" University of Rome, Rome, Italy.
authors: Nefer
authors: N
authors: Fallico
authors: Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan, Republic of China.
authors: Hung-Chi
authors: HC
authors: Chen
authors: Department of Plastic and Reconstructive Surgery, University of Sassari, Sassari, Italy.
authors: Mario
authors: M
authors: Faenza
authors: Department of Plastic and Reconstructive Surgery, University of Sassari, Sassari, Italy.
authors: Alfonso
authors: A
authors: Bolognini
authors: Department of Plastic and Reconstructive Surgery, "Sapienza" University of Rome, Rome, Italy.
authors: Andrea
authors: A
authors: Armenti
authors: Department of Plastic and Reconstructive Surgery, Sant'Andrea Hospital, Rome, Italy.
authors: Fabio
authors: F
authors: Santanelli Di Pompeo
authors: Department of Plastic and Reconstructive Surgery, University of Salerno, Fisciano Salerno, Italy.
authors: Corrado
authors: C
authors: Rubino
authors: Department of Plastic and Reconstructive Surgery, University of Sassari, Sassari, Italy.
authors: Gian Vittorio
authors: GV
authors: Campus
mesh_terms: D000328:Adult; D000368:Aged; D001785:Blood Gas Monitoring, Transcutaneous; D019299:Decompression, Surgical / Q000379:methods; D003929:Diabetic Neuropathies / Q000601:surgery*; D005500:Follow-Up Studies; D005528:Foot / Q000098:blood supply*; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011446:Prospective Studies; D013641:Tarsal Tunnel Syndrome / Q000601:surgery*; D016896:Treatment Outcome