경증의 당뇨발에서 창상치유 예측인자로서의 경피산소분압치

Abstract

Purpose: Microcirculation of diabetic patients is commonly comporomised, regardless of the condition of the macrocirculation. Therefore, direct tissue oxygenation measurement is recommended in determining tissue viability and predicting wound healing potential. This study was designed to determine cut-off value of the tissue oxygenation in predicting wound healing in diabetic foot patients. Methods: This study included 41 feet of 41 diabetic foot patients who were treated in the Diabetic Wound Center of author’s institution between January and June, 2009. Main inclusion criteria were type 1 or 2 diabetes and a foot ulcer (duration > 3 weeks) and ulcer area(from 1cm^2 to 4cm^2). Measurements of the area of diabetic foot ulcer were carried out before treatment. Transcutaneous oxygen pressure(TcpO_2) was measured at adjacent site of ulcer. The healing wound was defined as complete wound closure within 12 weeks. Results: Average diabetic foot ulcer areas with healing and nonhealing wounds were 2.67±0.76 and 2.59±0.75 cm2, respectively. There was no significant difference in the wound area between the groups. Average foot TcpO_2 in healing and nonhealing wounds were 68.56±23.07 and 30.98±16.66mmHg, respectively(p<0.01). The rate of healing wound increased as TcpO_2 increased. In particular, TcpO_2 lower than 40mmHg and higher than 40mmHg showed the most significant difference(wound healing rates of 25% and 71%, respectively). Conclusion: Based on the results of the study, the minimal TcpO_2 value thought to be required for adequate wound healing in diabetic wounds(cut-off value) is 40 mmHg.