Moon H, Strauss MB, La SS, Miller SS, et al.
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, In.... Date of publication 2016 Jan 1;volume 43(6):641-648.
1. Undersea Hyperb Med. 2016 Sept-Oct;43(6):641-648.
The validity of transcutaneous oxygen measurements in predicting healing of
diabetic foot ulcers.
Moon H(1), Strauss MB(2), La SS(2), Miller SS(2).
Author information:
(1)Department of Mathematics and Statistics, California State University Long
Beach, Long Beach, California, U.S.
(2)Department of Hyperbaric Medicine, Long Beach Memorial Medical Center, Long
Beach, California, U.S.
INTRODUCTION: In 2002 Fife and Strauss (Fife, et al. Wound Rep Reg, 10:198-207;
Strauss, et al. Foot Ankle Intl, 23:933-937) studied the predictability of
transcutaneous oxygen measurements (TCOMs) for healing diabetic foot ulcers
(DFUs). This paper analyzes the validity of the two studies and combines their
information to predict which DFU will heal with adjunctive hyperbaric oxygen
(HBO₂) treatments.
METHODS: A statistical review of the Fife and Strauss papers was performed. The
numbers presented in the papers were subjected to analyses to compare like by
like data as well as test for p-values and odds ratios for predicting healing of
DFUs with HBO₂.
RESULTS: In the Strauss paper 143 subjects were studied in retrospective and
prospective series. In those TCOMs which exceed 200 mmHg with HBO₂ healing
occurred in 87.5% even if the room air TCOM was ⟨ 30 mmHg (p ⟨ 0.001). The Fife
paper studied retrospectively a subset of 221 patients who had TCOMs with HBO₂.
Failure rates for healing decreased progressively from 35.7% to 14.3%, with TCOMs
grouped in 100-mmHg increments from 200 mmHg to 699 mmHg. This resulted in
absence of statistical significance for any 100-mmHg range over 200 mmHg with
HBO₂ due to the small number of subjects for each 100-mmHg grouping.
CONCLUSIONS: Although differences exist between the study designs, each
complements the other. If TCOMs exceed 200 mmHg with HBO₂, both authors observed
that almost 90% of DFUs healed regardless of the room air readings when HBO₂ was
used as an adjunct to management.
PMID: 28768391 [Indexed for MEDLINE]
Conflict of interest statement: The authors of this paper declare no conflicts of
interest exist with this submission.
