在下肢慢性全层皮肤缺血（CLTI）患者的临床实践中，经皮氧分压（TcPO2）值可预测伤口愈合时间。

TcPO2 Value Can Predict Wound Healing Time in Clinical Practice of CLTI Patients.

作者信息

Woo Youngje, Suh Young Ju, Lee Hwasun, Jeong Eunsun, Park Sun Cheol, Yun Sang Seob, Kim Jang Yong

机构信息

Geochang public health center, Republic of Korea.

Department of Biomedical Sciences, College of Medicine, Inha University, Incheon, Republic of Korea.

出版信息

Ann Vasc Surg. 2023 Apr;91:249-256. doi: 10.1016/j.avsg.2022.11.020. Epub 2022 Dec 8.

DOI:10.1016/j.avsg.2022.11.020

PMID:36503018

Abstract

BACKGROUND

Transcutaneous oxygen pressure (TcPO2) is a noninvasive, nonradiological test to measure local oxygen released from capillaries through the skin. Since it reflects the metabolic state of the lower limb, it can predict wound healing in patients with critical limb threatening ischemia (CLTI). The purpose of this study was to determine the effectiveness of TcPO2 test in evaluating wound healing potential of patients with CLTI.

METHODS

This was a retrospective, single-center, nonrandomized, and observational study. A prospectively registered database of patients who visited Vascular Surgery Department of St. Mary's Hospital for CLTI and underwent TcPO2 tests from October 1, 2015 to July 1, 2021 was reviewed. Patients were divided into 2 groups: (1) those who had amputation only; and (2) those who underwent revascularization procedures. Patients whose wound healing status could not be determined were excluded. The clinical characteristics of patients, patient characteristics related to lower TcPO2 value, treatment success rate, and time for the wound to be healed were analyzed.

RESULTS

A total of 84 patients were included in this study. There was no difference in background patient characteristics between the 2 groups despite better survival within 12 months and shorter healing time in the revascularization group. A total of 76 patients survived 12 months after surgery, and 63 patients were healed. Higher HbA1c, higher serum creatinine, history of stroke, and history of coronary artery disease were related to lower TcPO2 value on multiple linear regression. The cutoff value of TcPO2 was determined to be 40 mm Hg for predicting wound healing. This value was similar to those of previous studies. In addition, there was a negative correlation between TcPO2 and wound healing time. Correlations among the anklebrachial index (ABI), toe-brachial index (TBI), and TcPO2 were not determined because ABI and TBI for some patients could not be obtained due to wound condition.

CONCLUSIONS

The TcPO2 value can predict the wound healing process of ischemic lower extremity injury.

摘要

背景

经皮氧分压（TcPO2）是一种用于测量通过皮肤从毛细血管释放的局部氧气的非侵入性、非放射性检测方法。由于它反映了下肢的代谢状态，因此可以预测严重肢体缺血（CLTI）患者的伤口愈合情况。本研究的目的是确定TcPO2检测在评估CLTI患者伤口愈合潜力方面的有效性。

方法

这是一项回顾性、单中心、非随机观察性研究。对2015年10月1日至2021年7月1日期间因CLTI就诊于圣玛丽医院血管外科并接受TcPO2检测的患者的前瞻性注册数据库进行了回顾。患者分为两组：（1）仅接受截肢的患者；（2）接受血管重建手术的患者。排除伤口愈合状态无法确定的患者。分析了患者的临床特征、与低TcPO2值相关的患者特征、治疗成功率以及伤口愈合时间。

结果

本研究共纳入84例患者。两组患者的背景特征无差异，尽管血管重建组在12个月内的生存率更高且愈合时间更短。共有76例患者术后存活12个月，63例患者伤口愈合。在多元线性回归中，较高的糖化血红蛋白、较高的血清肌酐、中风病史和冠状动脉疾病史与较低的TcPO2值相关。确定TcPO2的临界值为40 mmHg用于预测伤口愈合。该值与先前研究的值相似。此外，TcPO2与伤口愈合时间呈负相关。由于部分患者因伤口情况无法获得踝肱指数（ABI）和趾肱指数（TBI），因此未确定ABI、TBI与TcPO2之间的相关性。