Use of consecutive transcutaneous oxygen measurement when assessing the need for revascularization and association with the outcomes of ischemic diabetic ulcers

Abstract

This study compared the ankle-brachial index (ABI) with transcutaneous oxygen pressure (TcPO₂) in assessing peripheral vascular disease (PVD) prevalence in 100 diabetic foot ulcer (DFU) patients. Patients were categorized into vascular or nonvascular reconstruction groups and underwent both ABI and TcPO₂ measurements four times over 6 months. Predictive validity for PVD diagnosis was analysed using the area under the receiver-operating characteristic curve (AUC). The study found TcPO₂ to be a superior predictor of PVD than ABI. Among the DFU patients, 51 with abnormal TcPO₂ values underwent vascular reconstruction. Only TcPO₂ values showed significant pretreatment differences between the groups and increased post-reconstruction. These values declined over a 6-month follow-up, whereas ABI values rose. For those with end-stage renal disease (ESRD), TcPO₂ values saw a sharp decrease within 3 months. Pre-reconstruction TcPO₂ was notably lower in amputation patients versus limb salvage surgery patients. In conclusion, TcPO₂ is more effective than ABI for evaluating ischemic limb perfusion and revascularization necessity. It should be prioritized as the primary follow-up tool, especially for ESRD patients.