Reliability of the Fluorescence-Sensitive Optical Sensor Measurement of TcPO2 and Susceptibility to Pressure Injury Around the Foot
Source abstract
Abstract
Pressure injuries (PIs) are typically characterized by lesions of the dermis and subcutaneous tissue; they result from a downward force exerted on the area between a bony prominence and an external surface. Transcutaneous oxygen pressure (TcPO2) measurements are a standardized method for measuring tissue oxygen pressure. Standardized TcPO2 measurement data are lacking in regions susceptible to pressure injury. It is unclear whether the absence of data can be attributed to the unreliability and variability of the measurements obtained. This study aimed to assess the reliability and repeatability of TcPO2 measurements conducted using a fluorescence-sensitive photo-optical sensor at three sites on the foot where PIs can occur but for which no data are available. Thirty volunteers participated in this study. TcPO2 was measured in two sessions, one week apart, at the lateral of the fifth metatarsal head, the styloid process, and the lateral malleolus of both feet. TcPO2 (mmHg) exhibited moderate reliability for the left fifth metatarsal and right fifth metatarsal styloid process (ICC: 0.575 and 0.624, respectively). The right fifth metatarsal and the right and left lateral malleoli demonstrated good and excellent reliability of the styloid process of the left fifth metatarsal, with ICC values of 0.810, 0.816, 0.763, and 0.900, respectively. The implementation of a fluorescence-sensitive photo-optical sensor for the measurement of TcPO2 in the designated regions yielded reliable and reproducible measurements.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Non-Invasive Vital Sign Monitoring · Cardiovascular and Diving-Related Complications · Balance, Gait, and Falls Prevention
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Graduate in Podiatry, Son Espases University Hospital, Plaça de l’Hospital, 3, 07012 Palma, Spain
Nursing Department, University of Valencia, 46010 Valencia, Spain
Frailty Research Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
Ulcers and Wounds Nursing Unit, La Fe University and Polytechnic Hospital, Avinguda de Fernando Abril Martorell, 106, 46026 Valencia, Spain
References (50)
Show source-provided references
1. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System10.1097/WON.0000000000000281 ↗
2. Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation10.1016/j.jaad.2018.12.069 ↗
3. Determinants of mortality among older adults with pressure ulcers10.1016/j.archger.2014.07.011 ↗
4. Determining the frequency of pressure ulcers incidence and associated risk factors in critical care patients: A 3-year retrospective study10.1111/iwj.70120 ↗
5. The preventive effect of seamless nursing care on pressure ulcer and related complications in elderly inpatients
6. The prevalence of pressure ulcers in Europe, what does the European data tell us: A systematic review10.12968/jowc.2019.28.11.710 ↗
7. Prevalencia de las lesiones cutáneas relacionadas con la dependencia en adultos hospitalizados en España: Resultados del 6.o Estudio Nacional del GNEAUPP 2022
8. Prevalencia de las lesiones cutáneas relacionadas con la dependencia en residencias de mayores y centros sociosanitarios de España: Resultados del 6.o Estudio Nacional del GNEAUPP 2022
9. Aetiology, risk factors and treatment of typical and atypical pressure ulcers in patients with traumatic brain injury: A narrative review10.1111/iwj.14788 ↗
10. The effect of pressure and shear on tissue viability of human skin in relation to the development of pressure ulcers: A systematic review10.1016/j.jtv.2017.04.003 ↗
11. Catella, J., Mahé, G., Leftheriotis, G., and Long, A. (2022). Reference Probe for TcpO2 at Rest: A Systematic Review. Diagnostics, 13.10.3390/diagnostics13010077 ↗
12. Prognostic performance of bedside tests for predicting ulcer healing and wound healing after minor amputation in patients prone to medial arterial calcification: A systematic review10.1177/1358863X241309326 ↗
13. Evaluation of the clinimetrics of transcutaneous oxygen measurement and its application in wound care10.1111/iwj.12356 ↗
14. Catella, J., Long, A., and Mazzolai, L. (2021). What Is Currently the Role of TcPO2 in the Choice of the Amputation Level of Lower Limbs? A Comprehensive Review. J. Clin. Med., 10.10.3390/jcm10071413 ↗
15. Leenstra, B., de Kleijn, R., Kuppens, G., Verhoeven, B.A.N., Hinnen, J.W., and de Borst, G.J. (2020). Photo-Optical Transcutaneous Oxygen Tension Measurement Is of Added Value to Predict Diabetic Foot Ulcer Healing: An Observational Study. J. Clin. Med., 9.10.3390/jcm9103291 ↗
16. Comparison of Photo-optical Transcutaneous Oxygen Tension Measurement with Electro-Chemical Transcutaneous Oxygen Tension Measurement in Patients with Arterial Claudication10.1016/j.avsg.2021.05.019 ↗
17. Analyses of transcutaneous oxygen pressure values stratified for foot angiosomes to predict diabetic foot ulcer healing10.1016/j.jtv.2023.10.003 ↗
18. Clinical workflow for personalized foot pressure ulcer prevention10.1016/j.medengphy.2016.04.017 ↗
19. Prevalence and incidence of pressure injuries among older people living in nursing homes: A systematic review and meta-analysis10.1016/j.ijnurstu.2023.104605 ↗
20. Reliability of transcutaneous oxygen tension measurement on the back of the hand and complex regional pain syndrome after stroke110.1016/j.apmr.2003.09.034 ↗
21. Reproducibility of Transcutaneous Oxygen Pressure Measurements in Persons with Spinal Cord Injury10.1016/j.apmr.2008.09.564 ↗
22. Intra-test and test-retest reliability of exercise oximetry in arterial claudication10.1016/j.mvr.2018.01.003 ↗
23. Henni, S., Hersant, J., Ammi, M., Mortaki, F.-E., Picquet, J., Feuilloy, M., and Abraham, P. (2019). Microvascular Response to the Roos Test Has Excellent Feasibility and Good Reliability in Patients with Suspected Thoracic Outlet Syndrome. Front. Physiol., 10.10.3389/fphys.2019.00136 ↗
24. Microcirculatory Assessment of Arterial Below-Knee Stumps: Near-Infrared Spectroscopy Versus Transcutaneous Oxygen Tension-A Preliminary Study in Prosthesis Users10.1016/j.apmr.2016.12.001 ↗
25. Reproducibility of proximal and distal transcutaneous oxygen pressure measurements during exercise in stage 2 arterial claudication
26. Test-retest Reliability and Minimal Detectable Change in Exercise Oximetry in Claudicants10.1016/j.avsg.2023.09.095 ↗
27. Munro, B.H. (2005). Statistical Methods for Health Care Research, Lippincott Williams & Wilkins.
28. Sample size and optimal designs for reliability studies10.1002/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E ↗
29. Pavlů, D., Pánek, D., Kuncová, E., and Thung, J.S. (2021). Effect of Blood Circulation in the Upper Limb after Flossing Strategy. Appl. Sci., 11.10.3390/app11041634 ↗
30. Serdar, C.C., Cihan, M., Yücel, D., and Serdar, M.A. (2021). Sample size, power and effect size revisited: Simplified and practical approaches in pre-clinical, clinical and laboratory studies. Biochem. Medica, 31.10.11613/BM.2021.010502 ↗
31. Statistical Methods for Assessing Measurement Error (Reliability) in Variables Relevant to Sports Medicine10.2165/00007256-199826040-00002 ↗
32. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research10.1016/j.jcm.2016.02.012 ↗
33. Gerke, O. (2020). Reporting Standards for a Bland-Altman Agreement Analysis: A Review of Methodological Reviews. Diagnostics, 10.10.3390/diagnostics10050334 ↗
34. Andrades-Ramírez, O., Ulloa-Díaz, D., Rodríguez-Perea, A., Araya-Sierralta, S., Guede-Rojas, F., Muñoz-Bustos, G., and CHIROSA RÍOS, L.J. (2024). Test–Retest Reliability of Concentric and Eccentric Muscle Strength in Knee Flexion–Extension Controlled by Functional Electromechanical Dynamometry in Female Soccer. Appl. Sci., 14.10.3390/app14198744 ↗
35. Oxygen tension gradients and heterogeneity in venous microcirculation: A phosphorescence quenching study10.1152/ajpheart.1997.272.5.H2233 ↗
36. Microvessel PO2 measurements by phosphorescence decay method10.1152/ajpheart.1993.265.4.H1434 ↗
37. Comparison of two devices for measuring exercise transcutaneous oxygen pressures in patients with claudication10.1024/0301-1526/a000454 ↗
38. Feasibility of Photo-Optical Transcutaneous Oxygen Tension Measurement During Revascularization of the Lower Extremity10.1016/j.avsg.2021.05.058 ↗
39. Pressure signatures can influence tissue response for individuals supported on an alternating pressure mattress10.1016/j.jtv.2017.05.001 ↗
40. Perfusion, tissue oxygenation and peripheral temperature in the skin of heels of healthy participants exposed to pressure: A quasi-experimental study10.1111/jan.14250 ↗
41. Establishing predictive indicators for the status of loaded soft tissues10.1152/jappl.2001.90.6.2231 ↗
42. Tissue temperature, flux and oxygen of sacral and trochanteric area under pressure of healthy subjects: A quasi-experimental study10.1016/j.jtv.2021.01.006 ↗
43. The influence of local heating on skin microcirculation in pressure ulcers, monitored by a combined laser Doppler and transcutaneous oxygen tension probe10.1046/j.1365-2281.2000.00275.x ↗
44. Alvaro-Afonso, F.J., Garcia-Alvarez, Y., Garcia-Morales, E.A., Flores-Escobar, S., De Benito-Fernandez, L., Alfayate-Garcia, J., Sánchez-Ríos, J.P., Puras-Mallagray, E., Malo-Benages, E.J., and Ramírez-Ortega, M. (2024). Determining the Best Noninvasive Test for Peripheral Arterial Disease Diagnosis to Predict Diabetic Foot Ulcer Healing in Patients Following Endovascular Revascularization. Healthcare, 12.10.3390/healthcare12161664 ↗
45. Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update)10.1002/dmrr.3644 ↗
46. Evaluating the effects of sedentary behaviour on plantar skin health in people with diabetes10.1016/j.jtv.2020.09.001 ↗
47. The correlation between transcutaneous oxygen pressure (TcPO2) and forward-looking infrared (FLIR) thermography in the evaluation of lower extremity perfusion according to angiosome10.1111/iwj.14431 ↗
48. Transcutaneous Oxygen Pressure Measurement in Diabetic Foot Ulcers: Mean Values and Cut-Point for Wound Healing10.1097/WON.0b013e3182a9a7bf ↗
49. The influence of epidermal thickness on transcutaneous oxygen pressure measurements in normal persons10.3109/00365518809085767 ↗
50. Theoretical basis of the transcutaneous blood gas measurements10.1097/00003246-198110000-00011 ↗