Transcutaneos Oxygen measurement as a predictor for foot ulcer healingin Diabetic patients O valor preditivo da Press o Transcutanea de O2 na cicatriza o de les es do pé diabético

Introduction: Transcutaneos oxygen tension (TcPO2) is a noninvasive method that reflects the balance between local oxygen supply and skin oxygenation and is particularly useful in evaluating diabetic vascular disease, because its measurements are not influenced by medial arterial calcifications. The aim of the present study was to determine the predictive value of TcPO2 for foot ulcer healing in diabetic patients submitted to a conservative treatment. Material/Methods: 127 diabetic patients (135 limbs) with chronic foot ulcers were prospectively evaluated. The age was 67, 2 ± 11, 8 years (mean ± SD) and the diabetes duration was 17,6 ± 9,8 years (mean ± SD). TcPO2 mapping (mmHg) of the involved limb was obtained. Conservative ambulatory treatment was prescribed and wound healing was routinely evaluated. The patients were divided into three groups according to the clinical outcome: complete wound healing, improved wound healing and impaired wound healing. Results: A significant correlation was found between the presence of infection and TcPO2 values, 26,24 ± 15, 04 (mean TcPO2 with infection ± SD) and 34, 14 ± 16, 9 (mean TcPO2 with no infection ± SD), p<0, 05 t test. Of the 55 limbs who deteriorated, 37 had TcPO2< 30 mmHg, while 39 of the 54 limbs with complete wound healing had TcPO2 d" 30 mmHg (p<0,02) (table 1).When a cutoff value of 30 mmHg was used for ulcer healing a positive predictive value of 75% was found. Conclusions: This prospective study shows that TcPO2 evaluation is an accurately additional tool predictor to assess the ulcer healing outcome in diabetic patients. Introdu o: A avalia o da press o transcutanea de O2 (TcPO2) constitui um método n o invasivo de diagnóstico que nos permite quantificar a difus o de oxigénio a nível tecidular. Dado que a sua leitura é independente da calcifica o arterial a sua utiliza o na popula o diabética é de particular relevancia. O presente trabalho teve como objectivo avaliar o valor preditivo da TcPO2 relativamente á cicatriza o de les es do pé em doentes diabéticos submetidos a tratamento conservador. Material e Métodos: 127 pacientes diabéticos (135 membros) com úlceras crónicas foram avaliados prospectivamente tendo-se procedido, respectivamente á medi o dos valores da TcPO2. A idade média foi de 67, 2 ± 11, 8 anos (média ± dp) e o tempo médio de dura o da diabetes foi 17,6 ± 9,8 anos (média ± dp). No follow-up final, os doentes foram divididos em três grupos, de acordo com a evolu o clínica: cicatriza o completa, melhoria da cicatriza o e má evolu o da cicatriza o. Resultados: Houve corr