TRANSCUTANEOUS OXYGEN-TENSION IN PATIENTS WITH AND WITHOUT PERICAPILLARY FIBRIN CUFFS IN CHRONIC VENOUS INSUFFICIENCY, PORPHYRIA-CUTANEA-TARDA AND NON-VENOUS LEG ULCERS

To evaluate the influence of fibrin cuffs on the transcutaneous oxygen tension in patients with chronic venous insufficiency (CVI) we perfor med a prospective comparative study in an out-patient dermatological d epartment of a district hospital in the Netherlands. 16 patients with CVI grade II or III, 6 patients with porphyria cutanea tarda (PCT) wit hout any sign of CVI, 4 patients with clinical ecthyma type ulcers wit hout CVI and 10 healthy volunteers were studied. Skin biopsies for fib rinogen staining, transcutaneous oxygen tension measurements (TcPO2)an d light reflexion rheography (LRR) were performed. TcPO2 readings were significantly lower in patients with CVI compared to patients of the other groups. Fibrin cuffs were found in 8 out of 16 patients with CVI , all PCT patients and 3 out of 4 ecthyma-ulcer patients. On the basis of these results we conclude that the fibrin cuff alone does not act as a barrier for oxygen transport. Fibrin cuffs in CVI are not the cau se of venous ulceration but only a parr of the complicated mechanism o f the altered microcirculation induced by reflux in the venous macroci rculation. Fibrin cuffs are not unique for CVI but an indication of a disturbed microcirculation.