Transcutaneous oxygen and carbon dioxide measurements for determination of skin graft "take"

The feasibility of using transcutaneous partial pressure of oxygen (TCPO2) and transcutaneous partial pressure of carbon dioxide (TCPCO2) measurements as a way of determining skin graft "take" was investigated in 13 patients who received partial-thickness sheet grafts. Transcutaneous measurements were obtained from the graft and an area of normal skin starting on the day of surgery and then daily for 2 weeks. No complications or discomfort resulted from the determinations. Initially, graft TCPO2 was extremely low (less than 8 mm Hg) and never rose above a value of 30 to 40 mm Hg, whereas skin levels ranged between 60 and 80 mm Hg. Graft TCPO2 levels never approached skin levels until graft maturity was achieved. Graft TCPCO2 levels were 80 to 100 mm Hg on the first few days after grafting but decreased to levels just above those of the skin (40 to 50 mm Hg) by 5 to 6 days after grafting. Graft TCPCO2 normalized at the time of clinical graft vascularization and remained levels just above those of the skin throughout the remainder of the study. Graft TCPCO2 determinations provide a noninvasive and objective measure of skin graft vascularization, and graft TCPO2 values reflect graft maturity.