Transcutaneous oximetry (transcutaneous oxygen tension monitoring)

Measuring transcutaneous oxygen tension (TcpO2) is a method that allows you to assess skin oxygenation and blood microcirculation in the extremities. The percutaneous approach allows us to determine the condition of peripheral vessels and diagnose vascular disorders, including diabetic foot syndrome.

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Name and essence of the method

Transcutaneous oxygen tension (transcutaneous or transdermal oximetry) is a non-invasive method. It allows you to assess how well the tissues of the foot are saturated with oxygen.

Transcutaneous monitoring is widely used in various medical fields, including purulent, vascular, and plastic surgery. In anesthesiology and resuscitation, it is relevant for patients who require constant monitoring of oxygen and carbon dioxide.

Name and essence of the method

Indications for using the method

The transcutaneous oxygen tension (TcpO2) method allows you to assess the level of O2 saturation in the skin. This indicator is an indicator of the condition of peripheral vessels.

This method is also used to determine the need for amputation. This is relevant for critical ischemic syndrome.

Transcutaneous monitoring is also carried out for the purpose of:

  • Predicting wound healing The study of oxygen tension is actively used to determine the healing potential of trophic ulcers and extensive wounds in conditions of impaired blood supply.
  • Estimates of the effectiveness of vasodilators Transcutaneous oximetry helps evaluate how effectively medications dilate blood vessels and improve blood flow.
General information about the procedure

Research methodology

The measurement of transcutaneous oxygen is based on the ability of O2 molecules to penetrate the skin. The device used records the oxygen concentration directly under the skin. This correlates with the level of its saturation in the arteries. The value of transcutaneous O2 pressure directly depends on the volume of arterial blood flow.

In the process of studying pressure, a sensor is fixed to a fat-free area of ​​the patient's skin, which is preheated to a certain temperature. Heating the sensor increases local blood flow and facilitates the diffusion of O2 through the epidermis. Next, data on oxygen concentration is recorded. They are displayed in the form of a graph on the device monitor.

Preparation

Before starting the transcutaneous oximetry procedure, preparation is carried out. It looks like this:

  1. Adaptation. Before starting the procedure, the patient is placed in a warm room for 10-15 minutes. This allows you to stabilize microcirculation and avoid the influence of external factors on measurement results
  2. Exclusion of vasoconstrictors. It is impossible to cool the area under study, as this contributes to changes in blood circulation parameters. Against this background, oximetry results are distorted
  3. Assessment of the state of blood supply to the limb. For this purpose, physiological tests are used. The symmetry of pulsation in the arteries of the foot is also assessed. This is especially important for patients diagnosed with chronic arterial insufficiency at the stage of critical ischemia

In order to accurately assess the level and severity of lesions, duplex ultrasound scanning of the arteries of the lower extremities is also performed before the procedure. This test helps confirm the presence or absence of obstructions that could affect transcutaneous oxygen measurements.

Transcript of the study

High values ​​(above 30 mmHg) indicate good peripheral circulation. These indicators indicate a positive prognosis for wound healing. This is due to the fact that the tissues receive sufficient levels of oxygen.

Low values ​​(less than 20 mm Hg) indicate serious microcirculation disorders. Such values ​​are often associated with a low probability of successful wound healing. This is due to insufficient tissue oxygenation.

To accurately interpret the results, it is necessary to take into account other clinical indicators:

  • Dynamics of wound healing (monitoring changes in the condition of wound surfaces before and after surgery)
  • Pulsation in peripheral arteries (the presence or absence of pulsation provides additional information about the state of blood circulation)
  • Results of additional examinations (ultrasound, X-ray contrast angiography and CTA). They help assess the level and severity of arterial lesions
  • Laboratory research methods (blood tests and other tests). They help identify concomitant diseases that affect blood circulation, for example, chronic cardiac or venous insufficiency

The use of the transcutaneous method in combination with other diagnostic methods allows a more complete assessment of the patient’s health status. It also helps predict treatment outcomes and adequately plan therapeutic measures.

Advantages and disadvantages of the method

According to doctors, this method is valuable. Its main advantage is its non-invasiveness. This method is safe, including for those who suffer from chronic diseases.

The main disadvantage of the method is its sensitivity to conditions. The accuracy of measurements is sometimes compromised by environmental factors. Another disadvantage is data limitations. Their data quality may vary depending on the individual characteristics of the patient's body. In particular, oxygen transport is affected by the presence of glycated hemoglobin.

Advantages and disadvantages of the method
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