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
本文转载于J Clin Aesthet Dermatol. 2018;11(11):36–39,不代表本网站赞同其观点和对其真实性负责,我们只作于阅读分享,非商业用途,如若侵权,请告知删除。
原创: 十六点五 中山二院糖尿病足中心
进一步的清创就到了骨骼,对于骨髓炎最彻底的治疗方法就是去除被细菌侵袭的骨,正常的骨骼一般是浅黄色,如果发白或者变黑,往往就提示这段骨头可能活性比较差,另外,还有一种是面积比较大的骨暴露,一般的肉芽组织很难爬上去,因此,对于坏死的骨头及较大面积的骨暴露,一般需要清除。
皮下组织中的脂肪组织在足部分布广泛,而皮下脂肪中血管分布非常少,在相对或绝对缺血的糖尿病足中,脂肪组织边缘的是否出血不是其是否存活的可靠指标。
这是一个我们在《糖尿病足切开设计(1)》中提到过,这次从不同角度谈谈足趾的保全。
大趾是足部最重要的结构,如果被切除,对足部的功能会有比较大的影响,因此,应该尽可能的保存。
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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