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  Česky / Czech version Vnitř. Lék., 48, 2002, No. 10, p. 971 - 975
 
Transcutaneous Oxygen Tension in Hyperbaric as a Predictor of Ischaemia in Non-healing Diabetic Foot Ulcers 
Čechurová D.1, Rušavý Z.1, Lacigová S.1, Růžička J.2, Novák M.3, Jankovec Z.1 

1I. interní klinika Lékařské fakulty UK a FN, Plzeň, přednosta prof. MUDr. K. Opatrný, jr., CSc. 2Biofyzikální ústav Lékařské fakulty UK, Plzeň, přednosta MUDr. J. Beneš. 3Radiodiagnostická klinika Lékařské fakulty UK a FN, Plzeň, přednosta doc. MUDr. B. Kreuzberg, CSc.
 


Summary:

       The aim of the study was to evaluate the contribution of basal and modify transcutaneous oxygen tension measurement (TcpO2) to diagnosis of ischaemia and indication of angiography in non-healing diabetes foot ulcers: Method: 69 patients with non-healing diabetic ulcers localised on 76 legs underwent angiography (DSA) and basal and modify TcpO2 measurement after 100 % O2 exposition under normo- and hyperbaric conditions. Characteristic of patients: mean age 66 years (42 - 81), diabetes duration 14.3 years (1 - 36), glycated hemoglobin 7.9 % (±1,35). Results: Clinically important angiographic findings were obtained in 80 % (61/76) all ulcers. Basal TcpO2 < = 30 mm Hg was detected in 82 % diabetic ulcers with positive DSA (sensitivity - SN). The specificity (SP), positive and negative predictive value (PPV, NPV), relative risk (RR) and accuracy (A) of test were 60 %, 89 %, 47 %, 1.7 and 78 % respectively. TcpO2 with hyperbaric 100 % O2 was determined as the strongest predictor of ischaemia by statistical logistic regression. SN (91 %), SP (77 %), PPV (94 %), NPV (67 %, RR (2.8) and A (88 %) of test were increased (cut off 270 mmHg). Conclusion: TcpO2 measurement contributes to the diagnosis of ischaemia in non-healing diabetic ulcers. Modify TcpO2 increases the test value.

        Key words: TcpO2 - Non-healing defect - Diabetic foot - Angiography - Hyperbarism conditions
       

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