Selection of lower limb amputation level not aided by transcutaneous pO<sub>2</sub> measurements

Falstie-Jensen, N; Christensen, Knud Stenild; Brøchner‐Mortensen, Jens

doi:10.3109/17453678909149326

Cited by 10 publications

(2 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7,8 Despite the use of TcPO 2 in clinical practice, its added value for the diagnosis and evaluation of therapy in patients with CLTI is strongly debated as studies have shown poor to moderate reliability and reproducibility. [9][10][11][12][13] A recent review on TcPO 2 reported a sensitivity ranging from 0.61 to 0.82 for the prognosis of diabetic foot ulcer (DFU) healing. 12 Moreover, reported TcPO 2 threshold values for the detection of ischemia or potential non-healing DFUs differ significantly.…”

Section: Introductionmentioning

confidence: 99%

Applicability of Transcutaneous Oxygen Tension Measurement in the Assessment of Chronic Limb-Threatening Ischemia

et al. 2019

View full text Add to dashboard Cite

Transcutaneous oxygen tension measurement (TcPO2) is widely applied for the evaluation of chronic limb-threatening ischemia (CLTI). Nevertheless, studies that focused on the clinical value of TcPO2 have shown varying results. We identified factors that potentially play a role in TcPO2 measurement variation such as probe placement, probe temperature, and the use of a reference probe. In this review of the current literature, we assessed the application of these factors. A systematic search was conducted. Parameters that were assessed were probe placement, probe temperature, and mentioning and/or use of a reference probe. In total, 36 articles were eligible for analysis. In 24 (67%) studies, probes were placed on specific anatomical locations. Seven (19%) studies placed probes, regardless of the location of the ulcer, adjacent to an ischemic lesion or ulcer (perilesion). Selected temperature setting of the probe differed; in 18 (50%), a default probe temperature of 44°C was selected, and in 13 (36%), a different temperature was selected. In 31 (84%) studies, the use of a reference probe was not reported. Transcutaneous oxygen tension measurement is applied diversely in patients with CLTI. Homogeneity in TcPO2 protocols is warranted for reliable clinical application and to compare future TcPO2 research.

show abstract

Section: Introductionmentioning

confidence: 99%

Applicability of Transcutaneous Oxygen Tension Measurement in the Assessment of Chronic Limb-Threatening Ischemia

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Measurement of Po 2 (partial pressure of O 2 ) in tissues by surface probes has been used in the past to estimate the level of amputation required in ischaemic limbs with various degrees of success [16][17][18]. The system used at the time employed multiwire surface electrodes covering a wide surface area which resulted in heterogeneous values due to high mixed venous Po 2 [19].…”

Section: Introductionmentioning

confidence: 99%

Measurement of critical lower limb tissue hypoxia by coupling chemical and optical techniques

et al. 2005

View full text Add to dashboard Cite

It has been a long-term goal to develop non-invasive methods that can detect critical levels of tissue hypoxia to help in the management of chronic lower limb ischaemia. In the present study, skeletal muscle oxygenation was measured using a new Clark-type TCPO2 [transcutaneous PO2 (partial pressure of O2)]/PCO2 (partial pressure of CO2) monitoring system and optical NIRS (near-infrared spectroscopy) at graded levels of hypoxaemia using a rabbit model (n=6). The TCPO2/PCO2 probe was placed on the shaved hindlimb to record SPO2 (skin PO2) and SPCO2 (skin PCO2) continuously. A pair of NIRS probes were placed on the limb to monitor HbO2 (oxyhaemoglobin) and Hb (deoxyhaemoglobin). Graded hypoxaemia was achieved by stepwise reductions of FiO2 (fraction of inspired O2) from 30% to 6%. Animals were allowed to recover after each episode of hypoxia at an FiO2 of 30% as indicated by normalized arterial blood PO2. There was a significant (P<0.05) decrease in SPO2 with all grades of hypoxaemia and no significant changes in SPCO2. There was a significant (P<0.05) increase in muscle Hb with all grades of hypoxaemia and a significant (P<0.05) decrease in HbO2 when FiO2 was below 15%. A significant correlation was found between the SPO2 and HbO2 (r=0.92, P<0.001) and both were significantly correlated with arterial blood PO2 (P<0.001). The new TCPO2/PCO2 system, in addition to its application for the assessment of conditions such as chronic venous insufficiency where alteration in skin oxygenation occurs solely, also has potential in conditions such as peripheral vascular disease where both skin and muscle oxygenation may be affected.

show abstract

A multidisciplinary approach and surgical tips in major amputations of diabetic patients

et al. 2012

View full text Add to dashboard Cite

We aim to describe the results obtained in major amputations (transtibial and transfemoral) of diabetic patients followed with a close combined approach (medical and surgical). We evaluated 37 cases with an average age of 73.55 years. All were admitted in our Diabetology Department where they were monitored and treated in order to reach a new balance concerning cardiac failure, anemia, and other pathologies. Then, the orthopedic surgeons operate choosing an adequate level for amputation and pointing about adequate stump covering, accurate vessel, perineural and periosteal hemostasis, and nerve thermoablation. Reading literature we discovered in our series an improvement concerning perioperative mortality, considering the high average age and the bad general conditions of our patients; at the same time, we obtained an improvement about neuromas and ghost limb syndrome versus literature. About walking capabilities we had similar results compared to previous papers, obtaining the worst results for thigh amputations.

show abstract

Selection of lower limb amputation level not aided by transcutaneous pO₂ measurements

Cited by 10 publications

References 10 publications

Applicability of Transcutaneous Oxygen Tension Measurement in the Assessment of Chronic Limb-Threatening Ischemia

Applicability of Transcutaneous Oxygen Tension Measurement in the Assessment of Chronic Limb-Threatening Ischemia

Measurement of critical lower limb tissue hypoxia by coupling chemical and optical techniques

A multidisciplinary approach and surgical tips in major amputations of diabetic patients

Contact Info

Product

Resources

About

Selection of lower limb amputation level not aided by transcutaneous pO2 measurements

Cited by 10 publications

References 10 publications

Applicability of Transcutaneous Oxygen Tension Measurement in the Assessment of Chronic Limb-Threatening Ischemia

Applicability of Transcutaneous Oxygen Tension Measurement in the Assessment of Chronic Limb-Threatening Ischemia

Measurement of critical lower limb tissue hypoxia by coupling chemical and optical techniques

A multidisciplinary approach and surgical tips in major amputations of diabetic patients

Contact Info

Product

Resources

About

Selection of lower limb amputation level not aided by transcutaneous pO₂ measurements