Jirkovska Jarmila, Venerova Johana, Solar Svatopluk, Vedralova Lenka, Zavoral Miroslav

1. Diabetic Foot Ulcer
Healing In Relationship
With
Initial Transcutaneous
Oxygen Pressure
Jirkovska J., Venerova J., Solar
S., Vedralova L., Zavoral M.
Charles University in Prague,
First Faculty of Medicine,
Medical Dpt of the First Faculty of
Medicine and Central Military Hospital,
Prague, Czech Republic

2. • According to the international guidelines
(TASC II; International Consensus on the
Management and Prevention of the Diabetic
Foot 2011):
TcPO2 < 30 mmHg
→ predicts low healing
TcPO2 > 50 mmHg
→ high probability of healing
Aims
1. to observe healing of diabetic foot
ulcer (DFU) within 6 and 12 months
2. to study relationship with initial
TcPO2 30 and 40mmHg tresholds of
ischaemia
• Transcutaneous oxygen pressure (TcPO2)
is non-invasive method detecting
peripheral arterial disease (PAD).

3. Methods
• 53 diabetics included 02/2010 – 10/2012
• Inclusion criteria:
→ DFU Wagner ≥ 2
→ clinical suspition on PAD
• TcPO2 measured during the initial visits
at foot clinic (Radiometer TCM 400)
Age (years) 68.2 ± 11.9
Gender (% females) 24
Type of diabetes (% T2D) 87
Duration of diabetes (years) 17.9 ± 15.6
HbA1c (mmol/mol) 71 ± 16
Treatment of diabetes (%) 36 OAD, 36 insulin,
28 OAD + insulin
Wagner (%) W2 47 / W3 44 / W4 9
Osteomyelitis (%) 36
Active smoking (%) 24
Data = mean ± 1SD
Characteristics of patients:

4. Results 1
PAD +
76 %
PAD -
24 %
PAD +
81 %
PAD -
19 %
↓
76% TcPO2≤30mmHg
↓
81% TcPO2≤40mmHg
25
9
7
4
HEALING IN 6 MONTHS
32
6
4
2
1
HEALING IN 12 MONTHS
Healed 6M without
amputation
Low amputation
Non-healed without amputation
High amputation
Healed high amputation
Non-healed low amputation
Healed low amputation
Non-healed without amputation
Healed 12M without
amputation
45/53 patients completed the 12-months follow-up.

5. Conclusions
Results 2
TcPO2
≤ 30mmHg
TcPO2
≤ 40mmHg
TcPO2
≤ 30mmHg
TcPO2
≤ 40mmHg
sensitivity 85 % 95 % 85 % 92 %
specificity 40 % 36 % 34 % 28 %
PPV 53 % 54 % 34 % 34 %
NPV 77 % 90 % 85 % 90 %
12-months results of healing correspond with
6-months follow-up.
We found trend of higher sensitivity and NPV
of TcPO2 40mmHg treshold to healing both for
6/12 months period compared to 30mmHg.
Use of 40mmHg TcPO2 treshold in detection
of ischaemia in diabetic foot patients is
helpful.
Acknowledgement
The study was supported by grant MO 0901-8-8140.
HEALING IN 6 MONTHS HEALING IN 12 MONTHS