Tissue salvage by mapping of skin surface transcutaneous oxygen tension index
C. J. Hauser
Division of Surgery, Hollywood Presbyterian Medical Center, Los Angeles, CA 90027.
Healing of both pathologic and surgical wounds is strongly dependent on
adequate skin blood flow and oxygenation. The transcutaneous oxygen tension
(PtcO2) index (regional PtcO2 index = RPI = limb PtcO2/chest PtcO2) and
wound healing were assessed prospectively in 159 wounds in 113 high-risk
patients referred for standard noninvasive tests. Patients were managed by
referring practitioners on the basis of clinical assessment and standard
tests. Treatment was divided into local procedures and amputations. Of 93
local procedures, 48 healed (RPI = 0.72 +/- 0.10 [mean +/- SD]) and 45
failed (RPI = 0.25 +/- 0.12). Of 66 amputations, 45 healed (RPI = 0.64 +/-
0.09) and 21 failed (RPI = 0.28 +/- 0.11). Well-oxygenated skin healed
reliably regardless of the cause of the wound. Regional skin oxygenation
studies aid rapid diagnosis of ischemia and allow maximal conservation of
tissue in limb salvage situations.
