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PREDICTING HEALING OF LOWER LIMB ULCERS
Author(s) -
McMahon J. H. A.,
Grigg M. J.
Publication year - 1995
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1995.tb00601.x
Subject(s) - medicine , leg ulcer , lower limb , surgery
Management of ischaemic ulcers in patients with compromised peripheral arterial circulations relies on the physical examination and the simple, non‐invasive assessment of arterial supply. This study aims to determine if transcutaneous oxygen pressure (tc P o 2 ) measurement can improve management decisions based on ankle or toe systolic blood pressure measurement. Twenty‐two consecutive patients with ischaemic ulcers had tc P o 2 , measured and the ankle/brachial (ABI) and toe/brachial (TBI) indices calculated. Two months after surgery 12 of 22 (55%) ulcers were healing and 10 (45%) were indolent. Postoperative tc P o 2 values were predictive of wound outcome ( P <0.001). A tc P o 2 > 31 mmHg was invariably associated with healing whilst a tc Po 2 , 28 mmHg was associated with indolence. Anklebrachial indices and TBI were unable to be calculated in all patients due to falsely elevated pressures and hallux amputations, respectively, and neither was predictive of outcome (ABI P = 0.152, TBI P = 0.069). The response to revascularization was less in diabetic patients with a mean tc P o 2 increase of 18 mmHg compared to non‐diabetic patients with a mean tc P o 2 increase of 37 mmHg. Tc P o 2 measurement appears to be a reliable technique that can influence ischaemic ulcer management.