Clinical parameters and transcutaneous oxygen measurements for the prognosis of venous ulcers

Few data exist on the prognosis of venous ulcers. We therefore prospectively studied 14 patients with severe venous ulcers for up to 18 months and examined various possible prognostic factors, including transcutaneous oxygen tension (TcPO2) measurements of skin next to the ulcers. The ulcers had been present for a mean duration of 15.6 months before referral to our clinic. During the study only four patients (29%) had ulcers that were healed with conservative management consisting of topical and systemic antibiotics and conventional and occlusive dressings. We observed that the number of ulcers, their duration before admission to the study, and the extent of lipodermatosclerosis were more pronounced in the unhealed group. For all patients the mean ulcer TcPO2 level (5.6 +/- 1.5 mm Hg, mean +/- standard error) was significantly reduced when compared with the control chest site (62.4 +/- 2.1 mm Hg) (p less than 0.001; paired t test). The mean ulcer TcPO2 was not significantly different between the healed (4.5 +/- 2.0 mm Hg) and unhealed groups (6.1 +/- 2.0 mm Hg). We conclude that TcPO2 levels may not be predictive of the response to therapy in venous ulcers. TcPO2 levels may be markedly reduced, but even extremely low levels are not incompatible with healing.