Assessment of perfusion in the diabetic foot by regional transcutaneous oximetry

Regional transcutaneous oximetry is a new, noninvasive diagnostic technique for the investigation of peripheral vascular disease (PVD) that uses differences in limb and trunk transcutaneous PO2 to assess the adequacy of local perfusion. The application of such measurements would be of great importance in diabetes, in which limb ischemia is commonly difficult to assess. A group of diabetic subjects with symptomatic PVD was studied with regional oximetry, Doppler-assisted blood pressure measurements, and arteriography. Doppler studies correlated poorly to symptom grade and angiographic data, while oximetry clearly demonstrated limb hypoxia under the functional conditions appropriate to the patients' clinical symptomatology. The superiority of oximetry to Doppler studies was highly significant (X2 = 12.64, P less than 0.001). Regional transcutaneous oximetry should therefore be the noninvasive diagnostic test of choice in the initial evaluation of the diabetic limb for PVD. Because of its dependence on the adequacy of local oxygenation, transcutaneous oximetry is a powerful tool for investigation of the pathophysiology of PVD and will, in the future, have wide-ranging applications to the diagnosis and therapy of PVD.