POSTOPERATIVE TRANSCUTANEOUS OXYGEN MEASUREMENT IN THE PREDICTION OF DELAYED WOUND HEALING AND PROSTHETIC FITTING AMONG AMPUTEES DURING REHABILITATIONA Pilot Study
作者:
Stuart Yablon,
Ellen Novick,
Sudesh Jain,
Mary Inhoffer,
Daniel Graves,
期刊:
American Journal of Physical Medicine and Rehabilitation
(OVID Available online 1995)
卷期:
Volume 74,
issue 3
页码: 193-198
ISSN:0894-9115
年代: 1995
出版商: OVID
关键词: Transcutaneous Oxygen;Amputation;Wound Healing;Rehabilitation
数据来源: OVID
摘要:
Postoperative assessment of amputation wound healing remains largely subjective in nature, being based on the physician's clinical judgement. These considerations significantly impact on the rehabilitation course, as premature prosthetic fitting may result in wound breakdown. Alternatively, delayed healing may result in prolonged hospital length of stay. Few attempts have been made to correlate objective parameters of limb perfusion with amputation wound healing or prosthetic fitting outcome during the rehabilitation phase of treatment. A pilot study was conducted, in which the transcutaneous oxygen monitor, a noninvasive device measuring transcutaneous partial pressure of oxygen (tcpO2), was applied to the stumps of 11 consecutive above-or below-knee amputees admitted for rehabilitation after amputation. All patients were tested within 1 wk of admission and 45 days of amputation. The treatment team was blinded as to the test results. A direct correlation was observed between wound healing outcome and tcpO2results (Fisher's exact test [FET],P=0.03), and no patient with a tcpO2of <15 mm Hg healed during their rehabilitation stay (FET,P= 0.006). TcpO2of <15 mm Hg was significantly correlated with prolonged length of stay (Point Biserial Correlation Coefficient [rpbi],=-0.835;P=0.01), delayed prosthetic fitting (rpbi=0.742;p=0.01), and poorer wound healing at admission (rpbi= 0.932;P=0.001). Postoperative tcpO2measurement may have use in objectively identifying patients at greater risk of delayed wound healing and prosthetic fitting, although further study is warranted.
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