Transcutaneous Oxygen Tension: Principles and Applications



Empiric means of assessing limb perfusion are not adequate due to lack of sensitivity and specificity. However, transcutaneous oxygen tension has proven to be a useful tool in the evaluation of chronic lower extremity ischemia (CLI). The unique design of the transcutaneous sensor makes it possible to obtain accurate measurements of oxygen (pO2) tension on the surface of the skin. Transcutaneous oxygen (tcpO2) measurements can be used for minor and major lower extremity amputation level determination. In addition, tcpO2measurements facilitate prospective management of diabetic as well as non-diabetic patients with CLI.


Transcutaneous oxygen measurement Transcutaneous oxygen monitoring Skin surface oxygen tension Prospective management of diabetic foot problems Chronic limb ischemia Peripheral arterial disease 


  1. 1.
    Baumbach P. Understanding transcutaneous PO2and PCO2measurements. Copenhagen: Radiometer A/S; 1986. p. 1–54.Google Scholar
  2. 2.
    Steenfos HH, Baumbach P. Transcutaneous PO2in peripheral vascular disease. Copenhagen: Radiometer A/S; 1986. p. 1–18.Google Scholar
  3. 3.
    Moosa HH, Peitzman AB, Makaroun MS, Webster MW, Steed DL. Transcutaneous oxygen measurements in lower extremity ischemia: effects of position, oxygen inhalation, and arterial reconstruction. Surgery. 1988;103(2):193–8.PubMedGoogle Scholar
  4. 4.
    Andrews KL, Boon AJ, Dib M, Liedl DA, Yacyshyn A, Yacyshyn V. The use of elevation and dependency to enhance the predictive value of transcutaneous oxygen pressure measurements in the assessment of foot amputation healing. PM R. 2010;2(9):829–34.PubMedCrossRefGoogle Scholar
  5. 5.
    Larsen JF, Jensen BV, Christensen KS, Egeblad K. Forefoot transcutaneous oxygen tension at different leg positions in patients with peripheral vascular disease. Eur J Vasc Surg. 1990;4:185–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Burgess EM, et al. Segmental transcutaneous measurements of PO2in patients requiring below the knee amputations for peripheral vascular insufficiency. J Bone Joint Surg Am. 1982;64:378–92.PubMedGoogle Scholar
  7. 7.
    Franzeck UK, et al. Transcutaneous PO2measurement in health on peripheral arterial occlusive disease. Surgery. 1982;91:156–63.PubMedGoogle Scholar
  8. 8.
    Friedmann LW. The prosthesis – immediate or delayed fitting? Angiology. 1972;23:513–24.CrossRefGoogle Scholar
  9. 9.
    Katsamouris A, et al. Transcutaneous oxygen tension in selection of amputation level. Am J Surg. 1984;147:510–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Malone JM, et al. Prospective comparison of noninvasive techniques for amputation level selection. Am J Surg. 1987;154:179–84.PubMedCrossRefGoogle Scholar
  11. 11.
    Ratliff DA, et al. Prediction of amputation healing: the role of transcutaneous PO2assessment. Br J Surg. 1984;71:219–22.PubMedCrossRefGoogle Scholar
  12. 12.
    Matsen FA, et al. The relationship of transcutaneous PO2and laser Doppler measurements in human model of local arterial insufficiency. Surg Gynecol Obstet. 1984;159:418–22.PubMedGoogle Scholar
  13. 13.
    Wyss CR, et al. Transcutaneous oxygen tension as a predictor of success after an amputation. J Bone Joint Surg Am. 1988;70:203–7.PubMedGoogle Scholar
  14. 14.
    Christensen KS, Klarke M. Transcutaneous oxygen measurement in peripheral occlusive disease: an indicator of wound healing in leg amputation. J Bone Joint Surg Br. 1986;68:423–6.PubMedGoogle Scholar
  15. 15.
    Ballard JL, Malone JM. Amputation in the diabetic. In: Rutherford RB, editor. Seminars in vascular surgery. Philadelphia: W.B. Saunders Co.; 1992. p. 257–63.Google Scholar
  16. 16.
    Malone JM, Ballard JL. Amputation level determination techniques. In: Bernstein EF, editor. Vascular diagnosis. St. Louis: Mosby-Year Book, Inc.; 1993. p. 568–74.Google Scholar
  17. 17.
    Kim D, Orron DE. Techniques and complications of angiography. In: Kim D, Orron DE, editors. Peripheral vascular imaging and intervention. St. Louis: Mosby-Year Book, Inc.; 1992. p. 83–109.Google Scholar
  18. 18.
    Weisberg LS, Kurnik PB, Kurnik BRC. Risk of radiocontrast neuropathy in patients with and without diabetes mellitus. Kidney Int. 1994;45:259–65.PubMedCrossRefGoogle Scholar
  19. 19.
    Hauser CJ, Klein SR, Mehringer CM, Appel P, Shoemaker WC. Superiority of transcutaneous oximetry in noninvasive vascular diagnosis in patients with diabetes. Arch Surg. 1984;119:690–4.PubMedCrossRefGoogle Scholar
  20. 20.
    Hauser CJ, Klein SR, Mehringer CM, et al. Assessment of perfusion in the diabetic foot by regional transcutaneous oximetry. Diabetes. 1984;33:527–31.PubMedCrossRefGoogle Scholar
  21. 21.
    Modesti PA, Boddi M, Poggesi L, et al. Transcutaneous oximetry in evaluation of the initial peripheral artery disease in diabetics. Angiology. 1987;38(6):457–61.PubMedCrossRefGoogle Scholar
  22. 22.
    Hauser CJ. Tissue salvage by mapping of skin surface transcutaneous oxygen tension index. Arch Surg. 1987;122:1128–30.PubMedCrossRefGoogle Scholar
  23. 23.
    Fronek A. Clinical experience with transcutaneous pO2and pCO2measurements. In: Bernstein EF, editor. Vascular diagnosis. St. Louis: Mosby-Year Book, Inc.; 1993. p. 620–5.Google Scholar
  24. 24.
    Lalka SG, Malone JM, Anderson GG, Hagaman RM, McIntyre KE, Bernhard VM. Transcutaneous oxygen and carbon dioxide pressure monitoring to determine severity of limb ischemia and to predict surgical outcome. J Vasc Surg. 1988;7(4):507–14.PubMedGoogle Scholar
  25. 25.
    Ballard JL, Eke CC, Bunt TJ, Killeen JD. A prospective evaluation of transcutaneous oxygen (TcPO2) measurements in the management of diabetic foot problems. J Vasc Surg. 1995;22:485–92.PubMedCrossRefGoogle Scholar
  26. 26.
    Padberg FT, Back TL, Thompson PN, Hobson RW. Transcutaneous oxygen (TcPO2) estimates probability of healing in the ischemic extremity. J Surg Res. 1996;60:365–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Petrakis E, Sciacca V. Prospective study of transcutaneous oxygen tension (TcpO2) measurements in the testing period of spinal cord stimulation in diabetic patients with critical lower extremity ischaemia. Int Angiol. 2000;19:18–25.PubMedGoogle Scholar
  28. 28.
    Wagner HJ, Schmitz R, Alfke H, Klose KJ. Influence of percutaneous transluminal angioplasty on transcutaneous oxygen pressure in patients with peripheral arterial occlusive disease. Radiology. 2003;226:791–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Pardo M, Alcaraz M, Ramón Breijo F, et al. Increased transcutaneous oxygen pressure is an indicator of revascularization after peripheral transluminal angioplasty. Acta Radiol. 2010;51:990–3.PubMedCrossRefGoogle Scholar
  30. 30.
    Arroyo CI, Tritto VG, Buchbinder D, et al. Optimal waiting period for foot salvage surgery following limb revascularization. J Foot Ankle Surg. 2002;41:228–32.PubMedCrossRefGoogle Scholar
  31. 31.
    Abraham P, Picquet J, Vielle B, et al. Transcutaneous oxygen pressure measurements on the buttocks during exercise to detect proximal arterial ischemia: comparison with arteriography. Circulation. 2003;107:1896–900.PubMedCrossRefGoogle Scholar

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© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Department of Vascular SurgerySt. Joseph HospitalOrangeUSA

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