COMPARISON OF HEATED-PROBE LASER DOPPLER AND TRANSCUTANEOUS OXYGEN MEASUREMENTS FOR PREDICTING OUTCOME OF ISCHEMIC WOUNDS

Transcutaneous oxygen (TcPO2) measurement has proven to be an accurate means of predicting healing of ischemic wounds. This study compares t he ability of TcPO2 and laser Doppler, modified by the addition of a h eated probe (LDHP), to assess wound outcome. TcPO2 and LDHP measuremen ts were made at the same site for 80 wounds, which consisted of 51 amp utations (25 above knee, 6 below knee, 20 forefoot) and 29 ulcerations . Healing was defined as complete wound closure. Failure to heal was d efined by the necessity for proximal amputation in 22 wounds (6 amputa tions, 16 ulcers). Outcome criteria were chosen to maximize accuracy a nd either positive or negative predictive values. Criteria with the gr eatest accuracy and positive predictive value for wound healing were g reater-than-or-equal-to 11 mmHg for TcPO2 and greater-than-or-equal-to 50 mv for LDHP range. Criteria with the most appropriate accuracy and negative predictive value for wound failure were <5 mmHg for TCPO2 an d <35 mv LDHP range. All wounds whose LDHP range was <35 mv failed to heal, whereas some wounds with a TcPO2 Of 0.1 mmHg healed successfully . An absolute prediction of wound healing (100% specificity and negati ve predictive value) was offered when either LDHP range was greater-th an-or-equal-to 125 mv or TCPO2 was greater-than-or-equal-to 33 mmHg, a lthough accuracy of either measurement at this criteria was unacceptab le for more general application. We conclude that TCPO2 or LDHP will a ssess wound outcome with similar overall accuracy, although each test may be better for predicting a specific outcome.