title: Influence of Negative-Pressure Wound Therapy on Tissue Oxygenation in Diabetic Feet.
abstract: OBJECTIVE
  Negative-pressure wound therapy (NPWT) has become a common wound care treatment modality for a variety of wounds. Several previous studies have reported that NPWT increases blood flow in the wound bed. However, NPWT might decrease tissue oxygenation in the wound bed because the foam sponge of NPWT compresses the wound bed under the influence of the applied negative pressure. Adequate tissue oxygenation is an essential consideration during diabetic foot management, and the foot is more sensitive to ischemia than any other region. Furthermore, the issue as to whether NPWT reduces or increases tissue oxygenation in diabetic feet has never been correctly addressed. The aim of this study was to evaluate the influence of NPWT on tissue oxygenation in diabetic feet.
  
  
  METHODS
  Transcutaneous partial oxygen pressures (TcPO2) were measured to determine tissue oxygenation levels beneath NPWT dressings on 21 feet of 21 diabetic foot ulcer patients.
  
  
  METHODS
  A TcPO2 sensor was fixed at the tarsometatarsal area of contralateral unwounded feet. A suction pressure of -125 mm Hg was applied until TcPO2 reached a steady state. The TcPO2 values for diabetic feet were measured before, during, and after NPWT.
  
  
  RESULTS
  The TcPO2 levels decreased significantly after applying NPWT in all patients. Mean TcPO2 values before, during, and after therapy were 44.6 (SD, 15.2), 6.0 (SD, 7.1), and 40.3 (SD, 16.4) mm Hg (P < .01), respectively.
  
  
  CONCLUSIONS
  These results show that NPWT significantly reduces tissue oxygenation levels in diabetic feet.
authors.affiliation: Jae-A Jung, MD, MSc, is a Professor, Department of Plastic Surgery; Ki-Hyun Yoo, MD, is a Resident, Department of Plastic Surgery; Seung-Kyu Han, MD, PhD, is a Professor, Department of Plastic Surgery; Ye-Na Lee, MSc, RN, CWCN, is a Certified Wound Care Nurse, Department of Plastic Surgery; Seong-Ho Jeong, MD, PhD, is a Professor, Department of Plastic Surgery; Eun-Sang Dhong, MD, PhD, is a Professor, Department of Plastic Surgery; and Woo-Kyung Kim, MD, PhD, is a Professor, Department of Plastic Surgery; all at Korea University Guro Hospital, Seoul, South Korea.
authors.forename: Jae-A
authors.initials: JA
authors.lastname: Jung
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Yoo
authors.forename: Seung-Kyu
authors.initials: SK
authors.lastname: Han
authors.forename: Ye-Na
authors.initials: YN
authors.lastname: Lee
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Jeong
authors.forename: Eun-Sang
authors.initials: ES
authors.lastname: Dhong
authors.forename: Woo-Kyung
authors.initials: WK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D048909:Diabetes Complications / Q000503:physiopathology / Q000628:therapy; D017719:Diabetic Foot / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D000860:Hypoxia / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects* / Q000379:methods; D010100:Oxygen / Q000032:analysis*; D010101:Oxygen Consumption / Q000502:physiology; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
chemical_list: D010100:Oxygen