Published online Nov 6, 2023. doi: 10.12998/wjcc.v11.i31.7570
Peer-review started: September 14, 2023
First decision: September 19, 2023
Revised: September 25, 2023
Accepted: October 23, 2023
Article in press: October 23, 2023
Published online: November 6, 2023
Transcutaneous oxygen pressure (TcpO2) is a precise method for determining oxygen perfusion in wounded tissues. The device uses either electrochemical or optical sensors.
To evaluate the usefulness of TcpO2 measurements on free flaps (FFs) in diabetic foot ulcers (DFUs).
TcpO2 was measured in 17 patients with DFUs who underwent anterolateral thigh (ALT)-FF surgery and compared with 30 patients with DFU without FF surgery.
Significant differences were observed in the ankle-brachial index; duration of diabetes; and haemoglobin, creatinine, and C-reactive protein levels between the two groups. TcpO2 values were similar between two groups except on posto
Even if the flap is clinically stable, sympathectomy due to adventitia stripping during anastomosis and arteriovenous shunt progression due to diabetic polyneuropathy could lead to low TcpO2 values in the ALT-FF owing to its thick fat tissues, which is supported by the slow recovery of the sympathetic tone following FF. Therefore, TcpO2 measurements in patients with DFU who underwent FF reconstruction may be less accurate than in those who did not.
Core Tip: Transcutaneous oxygen pressure (TcpO2) is measured low in free flap (FF) reconstruction for the following reasons. The flap itself is thick, making it difficult to accurately measure TcpO2, the adventitia stripping that occurs during vessel anastomosis semi-permanently reducing the sympathetic tone of the entire vessel, and the arteriovenous shunt caused by performing FFs and the progression of diabetes, thought to occur. For this reason, long-term periodic TcpO2 measurement is not useful when FF reconstruction is performed on diabetic foot ulcer.