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The International Journal of Lower Extremity Wounds
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A Review of the Clinical Significance of Tissue Hypoxia Measurements in Lower Extremity Wound Management

Daniel Mathieu, MD, PhD

Service d'Urgence Respiratoire, de Réanimation Médicale et de Médecine Hyperbare, Hôpital Calmette, Lille, France, dmathieu{at}chru-lille.fr

Raj Mani, PhD, FACA, DTech

Division of Diagnostics and Therapeutics, Southampton University Hospitals Trust, Southampton, United Kingdom

The aim of this paper is to review techniques that are currently available to measure tissue hypoxia in order to benefit the management of wounds. Direct measurement of tissue partial oxygen pressure (PO2) is invasive and therefore unappealing in clinical practice. Several techniques (PET scans, MRI derived techniques) are primarily applicable to research rather than clinical applications. Imaging techniques (duplex ultrasonography, arteriography, MRI techniques) are recommended only as part of the workup for revascularisation. Techniques that assess local perfusion include clearance methods, transcutaneous O2 and CO 2 pressure measurement, and laser Doppler flowmetry and imaging. These techniques permit interpretation of altered perfusion states. Each technique offers subtly different information concerning microvascular function. All these techniques require strict protocols to derive reliable data. The potential of the promising near infrared reflectance spectroscopy (NIRS) technique is yet to be determined.

Key Words: wound healing • peripheral arterial disease • tissue oxygen pressure • transcutaneous oxygen pressure • laser Doppler flowmetry • near infrared reflectance spectroscopy

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The International Journal of Lower Extremity Wounds, Vol. 6, No. 4, 273-283 (2007)
DOI: 10.1177/1534734607310299
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