Publication

Abstract : Peripheral Occlusive Vascular Disease impairs the healing process in diabetic foot ulcers. Ankle Brachial Index is the conventional method of assessing POVD and Transcutaneous Partial Pressure of Oxygen. It is a relatively newmeasure of assessing microvascular circulation. Our aim was to compare and contrast the utility of ABI and TcPO2 in predicting wound healing in diabetic foot ulcers. The study included 118 diabetic foot ulcer patients who had their ABI and TcPO2 measured. A handheld doppler device measured the ABI, and an electrochemical transducer measured the TcPO2 . Wound outcome was classified as either healed or not healed. The mean ABI in the healed group was 0.96±0.24 and 0.61±0.27 (p0.001) in the not healed group. The mean TcPO2 in the healed group was 33.77±15.51 and 23.29±14.77 (p=0.002) in the not healed group. The agreement rate of ABI with TcPO2 was 59.3%. More than 90% of ulcers with normal ABI and/or TcPO2 healed. With aggressive management of POVD a good percent of wounds with abnormal ABI and/or TcPO2 also healed. By plotting the ROC curve, in our population, an ABI value of 0.77 was found to have 80% sensitivity and 75% specificity, and a TcPO2 value of 22.5 mm Hg was found to have 74.4% sensitivity and 53.6% specificity in predicting wound healing. Both ABI and TcPO2 measured different aspects of POVD and were complementary in predicting wound healing in diabetic foot ulcers. The optimal cut-off values for both measures for ourpopulation were also defined.