POSTOPERATIVE TRANSCUTANEOUS OXYGEN MEASUREMENT IN THE PREDICTION OF DELAYED WOUND-HEALING AND PROSTHETIC FITTING AMONG AMPUTEES DURING REHABILITATION - A PILOT-STUDY

Postoperative assessment of amputation wound healing remains largely s ubjective in nature, being based on the physician's clinical judgement . These considerations significantly impact on the rehabilitation cour se, as premature prosthetic fitting may result in wound breakdown. Alt ernatively, delayed healing may result in prolonged hospital length of stay. Few attempts have been made to correlate objective parameters o f limb perfusion with amputation wound healing or prosthetic fitting o utcome during the rehabilitation phase of treatment. A pilot study was conducted, in which the transcutaneous oxygen monitor, a noninvasive device measuring transcutaneous partial pressure of oxygen (tcpO2), wa s applied to the stumps of 11 consecutive above-or below-knee amputees admitted for rehabilitation after amputation. All patients were teste d within 1 wk of admission and 45 days of amputation. The treatment te am was blinded as to the test results. A direct correlation was observ ed between wound healing outcome and tcpO2 results (Fisher's exact tes t [FET], P = 0.03), and no patient with a tcpO2 of less-than-or-equal- to 15 mm Hg healed during their rehabilitation stay (FET, P=0.006). Tc pO2 of less-than-or-equal-to-15 mm Hg was significantly correlated wit h prolonged length of stay (Point Biserial Correlation Coefficient [r( pbi], = -0.835; P = 0.01), delayed prosthetic fitting (r(pbi) = 0.742; p = 0.01), and poorer wound healing at admission (r(pbi) = 0.932; P=0 .001). Postoperative tcpO2 measurement may have use in objectively ide ntifying patients at greater risk of delayed wound healing and prosthe tic fitting, although further study is warranted.