Determination of transcutaneous oxygen tension for evaluating the degree of ischemia in patients with diabetic foot syndrome

Abstract

One of the main syndromes that poses a direct threat to the patient's ability to work and life is diabetic foot syndrome (DFS). It is known that DFS is caused by a complex of disorders of the anatomical and functional state of the foot due to neuro-ischemic changes caused by prolonged hyperglycemia. The aim of styding was to investigate the value of transcutaneous oxygen tension during the performance of revascularization and rehabilitation interventions in patients with DFS. We studied 114 patients with purulent-necrotic forms of DFS with moderate and severe diabetes, who were determined by the value of transcutaneous oxygen tension during hospital treatment.

Therefore, determination of transcutaneous oxygen tension is the most informative way to assess the degree of ischemia before and after revascularization operations. When the value of TcpO2 at the foot ≤25 mmHg we recommend performing the first stage of revascularization intervention. At TcPO2 values >25 mmHg, revascularization was recommended for post-primary remediation of purulent-necrotic lesions and to accelerate healing in patients with large foot tissue defects after surgery for purulent-necrotic complications of DFS. When restoring the value of the transcutaneous voltage above25 mmHg it can be performed remediation interventions at almost any distal level. At values of 10-25 mmHg – it should be done more proximal level (where the determined transcutaneous value of TcpO2 is about 15-25 mmHg) of the demarcation line necrosis, as the risk of reamputation is higher than 75 %. At values of ≤10 mmHg, we recommend performing high amputations.