McCollum P T, Spence V A, Walker W F
Br J Surg. 1986 Nov;73(11):882-5. doi: 10.1002/bjs.1800731108.
Transcutaneous oxygen (PtcO2) measurements were made on 46 patients with severe ischaemia of the lower limbs and on 17 age-matched controls. Values breathing air, 100 per cent oxygen and the rate of change of PtcO2 breathing oxygen were recorded. Of 29 below knee amputations there were 4 failures; 16 had PtcO2 values less than 35 mmHg, but 12 of the 16 healed. When the rate of change of PtcO2 during oxygen inhalation was greater than 9 mm Hg/min all below knee amputations healed; all 4 failures were found to have values less than 9 mm Hg/min while only one patient with a value of less than 9 mm Hg/min healed a below knee amputation. This study shows that low PtcO2 values are a poor indication of healing potential. A more reliable index of skin viability is provided by the dynamic measurement of PtcO2 changes during oxygen inhalation. The addition of an oxygen inhalation test, when making PtcO2 measurements, greatly enhances the applicability of the technique in the assessment of the oxygen supply to the skin.