Kyu-Il Lee1 , Yu-Kyeong Yun2 , Seung-Kyu Han2,3 , Kyung-Chul Moon2,3 , Sik Namgoong2,3 ,
Seong-Ho Jeong3 , Eun-Sang Dhong3
1Department of Plastic Surgery, Taean Public Health Office, Taean, Korea
2Diabetic Wound Center and Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Korea
3Department of Plastic Surgery, Korea University College of Medicine, Seoul, Korea
Abstract
Background: Adequate tissue oxygenation is a key determinant of diabetic foot ulcer (DFU) outcomes. Though transcutaneous oxygen pressure (TcPO2) is the gold standard for evaluating tissue oxygenation, its limited availability restricts routine clinical use. Consequently, toe pressure is frequently utilized as a practical surrogate; however, the direct correlation between these two modalities has yet to be rigorously investigated. This study aimed to assess the correlation and agreement between TcPO2and toe pressure in patients with DFUs.
Methods: A retrospective review was conducted on 837 DFU patients who received simultaneous TcPO2and toe pressure assessments.
The correlation between the two tests was analyzed using the Pearson correlation coefficient, and agreement was evaluated using Bland– Altman analysis. To aid interpretation, a scatterplot and Bland–Altman plot were generated.
Results: TcPO2and toe pressure demonstrated a strong correlation (R=0.66; 95% confidence interval, 0.62 to 0.70; P<0.001). Bland–
Altman analysis showed a mean bias of 26.9 mmHg (standard deviation of differences, 28.8 mmHg; 95% limits of agreement, −28.9 to 82.6 mmHg) between toe pressure and TcPO2, reflecting limited agreement and increased variability at higher perfusion levels.
Conclusion: TcPO2and toe pressure are strongly correlated. However, they are not interchangeable, particularly in DFU patients with high tissue perfusion.
Keywords: Diabetic foot; Foot ulcer; Ischemia; Microcirculation
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原创: 十六点五 中山二院糖尿病足中心
梁某,女,60岁,糖尿病病史7年,平时不规则用药,血糖控制一般。10余天前不小心刺伤左脚第2趾,到当地医院看病,感染扩散,当地医院建议截肢,患者要求转院于2018年10月27日转入我院。
截肢与保肢只差一个中山二院的距离
原创: 血管工程师 血管工程师
胡奶奶今年73岁高龄,10年前发现糖尿病,血糖一直控制不佳,还有高血压等疾病,3年前因右下肢静脉曲张在当地医院做过手术。1月前因左下肢无力、麻木,当地医院考虑为左下肢静脉曲张再次入院行左下肢静脉曲张手术。
张某,男,71岁,因多饮多尿26年,右足溃烂2年入院。
2016年无明显诱因下发现右脚第二脚趾皮肤溃烂发黑,后逐渐累及第一、第三及第四脚趾,周边皮肤发红,疼痛明显,伴低热,遂至外院就诊。
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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