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Measuring Transcutaneous Oxygenation to Validate the Duration Required to Achieve Electrode Equilibration

Chiang, Nathaniel, MBChB; Jain, Jitendra, K., MBBS, BMedSc; Sleigh, Jamie, MBChB, MD, FANZCA; Vasudevan, Thodur, MD, FRACS

Advances in Skin & Wound Care: June 2018 - Volume 31 - Issue 6 - p 263–269
doi: 10.1097/01.ASW.0000530847.49484.4b
FEATURES: ORIGINAL INVESTIGATIONS
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OBJECTIVE: The transcutaneous oxygenation measurement (TCOM) system is useful in assessing tissue viability. There are no clear recommendations regarding the duration required for the electrode to equilibrate and reliably evaluate tissue oxygenation values. The objective of this study was to validate the duration required to achieve electrode equilibration in a clinical setting.

METHODS: Minute-by-minute recordings using TCOM (TCOM3; Radiometer Medical ApS, Brønshøj, Copenhagen) were obtained for 82 limbs in 50 participants. Twenty-five limbs were in patients with peripheral vascular disease; 30 were in patients with no known peripheral vascular disease; and 27 were in healthy volunteers. Transcutaneous partial pressure of oxygen and carbon dioxide (TcPO2 and TcPCO2) were recorded over a 15-minute period.

RESULTS: Participants’ TcPO2 decreased and TcPCO2 increased over time. Both changed in a nonlinear fashion, eventually settling at an “equilibrium” where the measurements became stable. The difference in proportional change of TcPO2 between minutes 14 and 15 was 0.8%, and for TcPCO2was 2.9%. Changes in TCOM measurements over time were similar among the 3 groups.

CONCLUSIONS: This is the first study to target minute-by-minute variation in TcPO2 and TcPCO2 measurements. Recording for a minimum of 15 minutes allows a reliable period for the TCOM electrode to equilibrate to record absolute values and determine wound healing potential.

In the Department of Vascular Surgery, Waikato Hospital, Hamilton, New Zealand, Nathaniel Chiang, MBChB, is a Vascular Fellow; Jamie Sleigh, MBChB, MD, FANZCA, is Consultant Anesthetist; and Thodur Vasudevan, MD, FRACS, is Head of Unit and Consultant Vascular Surgeon. Jitendra K. Jain, MBBS, is Vascular Registrar, The Royal Melbourne Hospital, Melbourne, Australia. Part of this study was presented at the 2013 Annual Scientific Meeting of the Australian and New Zealand Society for Vascular Surgery, Hobart, Tasmania, October 12 to 15, 2015. This study was also given as an oral presentation at the 2017 Symposium of Advanced Wound Care Fall Meeting in Las Vegas, Nevada, October 2017. The authors have disclosed that this research was supported by funding from the University of Auckland, Waikato Medical Research Foundation, Health Research Council, and Royal Australasian College of Surgeons. The authors have disclosed no other financial relationships related to this article. Submitted August 14, 2017; accepted in revised form November 17, 2017.

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