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TcPO2 usage in surgery and wound care

Discussion in 'Diabetic Foot & Wound Management' started by nicpod1, Oct 19, 2004.

  1. nicpod1

    nicpod1 Active Member


    Members do not see these Ads. Sign Up.
    Is anyone using a TcPO2 machine? If so, I have only found Radiometer as a supplier (approx. £6800 for one modality, £11,000 for two), is anyone else better/cheaper and how reliable is it as a determinant of:
    a) Amputation level
    b) Healing potetntial?

    Any information would be gratefully received, before I have to put in a bid for nearly £7000!

    Thanks!
     
  2. davidh

    davidh Podiatry Arena Veteran

    Hi Nicola,
    No experience of this kit I'm afraid. I did a small search on it, and it seems to be quoted in most of the abstracts I looked at so it's probably ok :) .

    Given that £7000 is not such a lot for a piece of medical hardware, what do you estimate the difference the kit will make to outcomes?
    Do you, for example, believe it will provide better outcome-determinant data than a Tekscan vertical loading gait analysis mat, or are you looking to use it to augment modalities already in place?

    Regards,
    David
     
  3. nicpod1

    nicpod1 Active Member

    TcPO2

    Hi David,

    Possibly I didn't explain myself properly - I was requesting information on the use of this technology with respect to determining the level of ischaemia in diabetic patients, via tissue oxygen perfusion, which would then help to determine healing potential, amputation level and results following vascular intervention, not with respect to muscle function (is this what you thought I meant?)

    Either way, as there has been no response, I would suspect that not many people are using it!

    And yes, it is relatively inexpensive, but not when you only have £6000 to spend! :D

    Thanks David.
     
  4. davidh

    davidh Podiatry Arena Veteran

    Hi Nicola,
    I understood that, and looks like it was I who didn't explain myself clearly :eek: !

    With small lumps of cash being available in our NHS one has, more than ever, to look for "best value".
    I wonder(ed) how this equipment compares with force-plates, the use of which are reasonably well documented in the contexts of peripheral vascualr disease and diabetes(Cavanagh et al) when looking at elevated plantar pressures during ambulation?
    Regards,
    David
     
  5. sarannmacphee

    sarannmacphee Welcome New Poster

    I recently attended a national meeting for the launch of the DRAFT SIGN guidelines on Diagnosis and Management of Peripheral Arterial Disease, available for comment via the web site www.sign.ac.uk
    can I direct you to 3.3.6 Pulse Oximetry and 3.3.7 Near infra-red spectroscopy with attached references, which may make your decision clearer, I personally have no experience of TcPO2 meausurements but would be interested in what others have to say in non research areas.
    regards
    Sarann Macphee :p
     
  6. nicpod1

    nicpod1 Active Member

    Sarah,

    Thank you - I will chase this link up.

    David,

    With respect to load-bearing forces - I am purely thinking of TCPO2 with respect to ischaemia - no neuropathy involved - being lazy and on my way out to get a life - does the Cavanagh research refer to increased plantar forces with respect solely to iscahemia - no neuropathy?

    I intend to use this tool only as an indicator of healing potential and anticipated amputation level.......blah, blah, blaaaaahhhh (I'm boring myself now)!

    Thanks David!
     
  7. Tuckersm

    Tuckersm Well-Known Member

    Hand Held TCPO2 machines are available at about $800 US, and are used quite widely in the Physio world to assess pulse rate and tissue perfusion during exercise. These should be quite suitable for a clinic based assessment of lower limb tissue perfusion
     
  8. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Reference value of transcutaneous oxygen measurement in diabetic patients compared with nondiabetic patients.
    Meijer VE, Sant HP, Spronk S, Kusters FJ, Hoed PT.
    J Vasc Surg. 2008 Jun 20. [Epub ahead of print]
     
  9. LuckyLisfranc

    LuckyLisfranc Well-Known Member


    Stephen

    Do you have a product name or source for these units?

    LL
     
  10. Admin2

    Admin2 Administrator Staff Member

    Pulse oximetry index: a simple arterial assessment for patients with venous disease.
    J Wound Care. 2008 Jun;17(6):253-4, 256-8, 260
    Bianchi J, Zamiri M, Loney M, McIntosh H, Dawe RS, Douglas WS
     
  11. betafeet

    betafeet Active Member

    I am thinking of buying a Nellcor N100e Pulse Oximeter seeing this thread has been going since 2004 have any of you been using an Oximeter in this time?

    I am just wanting to use it for basic vascular assessment (seen one at a very good price second hand), but would like your informed thoughts!!!!!!!!

    jude
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Transcutaneous oximetry in clinical practice: consensus statements from an expert panel based on evidence.
    Fife CE, Smart DR, Sheffield PJ, Hopf HW, Hawkins G, Clarke D.
    Undersea Hyperb Med. 2009 Jan-Feb;36(1):43-53.
     
  13. HelenRobins

    HelenRobins Member

    Re: TcPO2

    I work on a multidisciplinary diabetic foot and ulcer team and we use the TCP02 machine fairly regularly as the ankle brachial indexes are often questionable in diabetic patients and the arterial duplex dopplers are often opperator dependant. It is often a quick way of determining whether to go ahead with extensive wound care or do vascular intervention first. We feel confident using the machine given the research available but it is important that the operator undergoes training first as placing the sensors in inappropriate areas can lead to incorrect readings

    Helen



     
  14. zuckerkranke Fußklinik

    zuckerkranke Fußklinik Welcome New Poster

    Hello,
    I am working in a Limb Salvage Clinic in Mexico, we use a 4 channel TCPO2 machine with excellent results for determining amputation level and pronostics. Be careful you guys with pulse oximetry, this is not the same, we are talking about oxigen tension, not photocromatic levels of hemoglobin with pulse oximetry. The incovinient is just the price of the equipment and the replacements, this are costly but worth of it, if the patients has ischaemic limb, and needs to know how will he do after surgery.

    Thanks
     
  15. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Increased Transcutaneous Oxygen Tension in the Skin Dorsum Over the Foot in Patients With Diabetic Foot Disease in Response to the Topical Use of an Emulsion of Hyperoxygenated Fatty Acids.
    Lázaro-Martínez JL, Sánchez-Ríos JP, García-Morales E, Cecilia-Matilla A, Segovia-Gómez T.
    Int J Low Extrem Wounds. 2009 Oct 13. [Epub ahead of print]
     
  16. syed mohammed

    syed mohammed Welcome New Poster

    Hello Nicol,

    This is Syed here from UAE.
    We have just introduced a new complete vascular lab equipment which can measure Toe Pressure, TCPO2, Amputation level, Ankle Pressure, Skin Perfusion Pressure, ABI(ANKLE BRACHIAL INDEX), Pulse Volume Recording and Heat Control Laser Doppler ALL IN ONE MACHINE.
    Yes you read it correct its ALL IN ONE MACHINE.

    If interested please feel free to contact +971503138490.
    Or mail me at syedmohammed@ibmms.com.

    Thanks & Regards.
     
  17. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
    1
    Can Macrocirculation Changes Predict Nonhealing Diabetic Foot Ulcers?
    Lee YN, Kim HS, Kang JA, Han SK.
    J Wound Ostomy Continence Nurs. 2014 September/October;41(5):430-435.
     
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