The Impact of the Micro-Lightguide O2C for the Quantification of Tissue Ischemia in Diabetic Foot Ulcers

• Published in: Diabetes care Vol. 27; no. 12; pp. 2863 - 2867
• Main Authors: BECKERT, Stefan, WITTE, Maria B, KÖNIGSRAINER, Alfred, COERPER, Stephan
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-12-2004
• Subjects: Adult; Associated diseases and complications; Biological and medical sciences; Blood Flow Velocity; Care and treatment; Diabetes; Diabetes. Impaired glucose tolerance; Diabetic foot; Diabetic Foot - blood; Diabetic Foot - physiopathology; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Feet; Foot - blood supply; Hemoglobins - metabolism; Humans; Ischemia; Ischemia - diagnosis; Medical procedures; Medical sciences; Middle Aged; Oxyhemoglobins - metabolism; Reference Values; Regional Blood Flow; Skin - blood supply; Spectrophotometry - instrumentation; Spectrophotometry - methods; Tissues; Ulcers; Wound Healing; United States; Endocrinopathy; Human; Skin disease; Nervous system diseases; Diabetic Foot; Diabetes mellitus; Cardiovascular disease; Exploration; Peripheral neuropathy; Microcirculation; Laser dopplerometry; Spectrometry; Ischemia; Disease of the foot; Ulcer; Peripheral nerve disease; Oxygenation
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.27.12.2863

The Impact of the Micro-Lightguide O2C for the Quantification of Tissue Ischemia in Diabetic Foot Ulcers
Stefan Beckert , DRMED, MD ,
Maria B. Witte , MD ,
Alfred Königsrainer , MD and
Stephan Coerper , MD
From the Department of General Surgery, University of Tübingen, Tübingen, Germany
Address correspondence and reprint requests to Dr.med. Stefan Beckert, Department of General Surgery, Hoppe-Seyler-Strasse
3, 72076 Tübingen, Germany. E-mail: stefan.beckert{at}med.uni-tuebingen.de
Abstract
OBJECTIVE —Tissue oxygen supply is crucial for wound healing. Especially in diabetic foot lesions, the chances for healing are mainly
dependent on the presence or absence of ischemia. This study investigates the impact of the tissue O2 analysis system “O2C”
for noninvasive quantification of tissue oxygenation in diabetic foot ulcer patients.
RESEARCH DESIGN AND METHODS —O2C assessed relative blood flow (flow), flow velocity (velo), and hemoglobin concentration (rHb) and hemoglobin oxygenation
(SO 2 ) at 2 and 6 mm depth (means ± SE). 1 ) Measurements were performed on intact skin of the forefoot and forearm of 20 healthy volunteers on 2 consecutive days. 2 ) Parameters were assessed on intact skin of the forefoot of diabetic foot ulcer patients ( n = 14). 3 ) Measurements were performed directly at the wound site in diabetic patients ( n = 14).
RESULTS — 1 ) Flow, velo, rHb, and SO 2 at 2 and 6 mm depth were not significantly different when measured at 2 consecutive days. 2 ) There were no significant differences between diabetic subjects and healthy volunteers. Only flow in 6 mm depth was significantly
higher in diabetic subjects (75 ± 13 vs. 51 ± 0.4 arbitrary units [AU], P < 0.05). When diabetic foot ulcer patients were split into healers and nonhealers, initial readings of SO 2 at 2 mm (32 ± 6 vs. 44 ± 3%, P < 0.05) and flow in 6 mm (28 ± 1 vs. 51 ± 0.6 AU, P < 0.05) were significantly reduced in nonhealers compared with control subjects, whereas in healers flow in 6 mm (70 ± 0.6
vs. 51 ± 0.6 AU, P < 0.05) was significantly higher than that in control subjects. 3 ) Initial SO 2 , rHb, flow, and velo were significantly lower in nonhealing compared with healing wounds.
CONCLUSIONS —O2C is a new reliable and valid method for noninvasive measurement of tissue oxygenation and microvascular blood flow in
patients with diabetic foot ulcers.
Footnotes
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
Accepted August 26, 2004.
Received June 15, 2004.
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