Tissue salvage by mapping of skin surface transcutaneous oxygen tension index

Healing of both pathologic and surgical wounds is strongly dependent on adequate skin blood flow and oxygenation. The transcutaneous oxygen tension (PtcO2) index (regional PtcO2 index = RPI = limb PtcO2/chest PtcO2) and wound healing were assessed prospectively in 159 wounds in 113 high-risk patients referred for standard noninvasive tests. Patients were managed by referring practitioners on the basis of clinical assessment and standard tests. Treatment was divided into local procedures and amputations. Of 93 local procedures, 48 healed (RPI = 0.72 +/- 0.10 [mean +/- SD]) and 45 failed (RPI = 0.25 +/- 0.12). Of 66 amputations, 45 healed (RPI = 0.64 +/- 0.09) and 21 failed (RPI = 0.28 +/- 0.11). Well-oxygenated skin healed reliably regardless of the cause of the wound. Regional skin oxygenation studies aid rapid diagnosis of ischemia and allow maximal conservation of tissue in limb salvage situations.