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Pulse oximetry: a new tool to assess patients with leg ulcers
J Bianchi1, W S Douglas, R S Dawe
1Department of Dermatology, Lanarkshire Acute Hospitals NHS Trust, (Monklands Hospital), Airdrie, Lanarkshire, UK.
Insights
Pulse oximetry aids in selecting patients for compression therapy for leg ulcers. This method shows fair correlation with ankle branchial pressure index (ABPI) and helps identify suitable candidates for treatment.
Area of Science:
- Vascular Medicine
- Dermatology
- Medical Diagnostics
Background:
- Graduated elastic compression is standard for venous leg ulcers.
- Significant arterial disease contraindicates compression therapy.
- Ankle branchial pressure index (ABPI) via Doppler ultrasound has limitations in assessing arterial insufficiency.
Purpose of the Study:
- Investigate pulse oximetry as a tool for assessing leg ulcer patients before treatment.
- Evaluate pulse oximetry as an alternative or additional method to ABPI for arterial assessment.
- Determine if pulse oximetry can aid in selecting patients for compression therapy.
Main Methods:
- Prospective controlled study on patients in hospital leg ulcer clinics.
- Evaluation of pulse oximetry (toe-finger oximetry index - TFOI) and Doppler ABPI.
- Selection for compression therapy based on pulse oximetry criteria.
- Monitoring ulcer healing time and rate in selected patient groups.
Main Results:
- A fair correlation was observed between the toe-finger oximetry index (TFOI) and Doppler ABPI.
- No significant difference in ulcer healing rates was found between patients with reduced and normal ABPI when selected by pulse oximetry.
- Pulse oximetry identified patients who would benefit from compression therapy but might be excluded by Doppler ABPI.
Conclusions:
- Pulse oximetry serves as a valuable aid in selecting patients for compression therapy for leg ulcers.
- It can help identify suitable candidates who might otherwise be excluded based on traditional ABPI assessment.
- Further investigation into pulse oximetry's role in managing leg ulcers is warranted.
Abstract:
The objective of the study was to investigate pulse oximetry as a guide to assessing patients with leg ulcers before treatment. Graduated elastic compression is the treatment of choice for uncomplicated venous leg ulcers, but is contra-indicated in patients with significant arterial disease. The standard assessment of arterial insufficiency by Doppler ultrasound ankle branchial pressure index (ABPI) has shortcomings which prompted this investigation of pulse oximetry as a possible additional, or alternative, method of assessment of patients with leg ulcers, prior to treatment with compression. The study, carried out on a population of patients attending hospital leg ulcer clinics, was designed to evaluate pulse oximetry assessment in the selection and monitoring of patients with venous leg ulceration leading to a prospective controlled study of ulcer healing in groups of patients with reduced and normal ABPI, selected for compression therapy by pulse oximetry criteria. Outcome measurement required follow-up of patients selected for compression therapy by pulse oximetry to record time to healing and rate of healing of leg ulcers. Results from the study show a fair correlation between the toe-finger oximetry index (TFOI) and Doppler ABPI. There is no difference between ulcer healing in patients with reduced and normal ABPI selected for treatment on the basis of pulse oximetry maximum compression pressure (MCP). In conclusion, pulse oximetry is an aid to the selection of patients who will benefit from compression therapy, but would be excluded on the basis of Doppler ABPI.