Comparison of Doppler and CT Angiography as a Predictor of Healing Diabetic Foot Ulcers.

Park, Doug John; Kim, Hyon Surk; Han, Seung Kyu; Kim, Hee Young; Chun, Kyung Wook; Kim, Woo Kyung

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(5):495-500.
Published online September 1, 2008.

Comparison of Doppler and CT Angiography as a Predictor of Healing Diabetic Foot Ulcers.

Doug John Park, Hyon Surk Kim, Seung Kyu Han, Hee Young Kim, Kyung Wook Chun, Woo Kyung Kim

¹Department of Plastic Surgery, Korea University, College of Medicine, Seoul, Korea. pshan@kumc.or.kr
²Department of Biostatistics, Korea University, College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Adequate tissue oxygenation is considered as an essential factor for wound healing. In the non- diabetic population, an uncompromised macrocirculation generally leads to adequate tissue oxygenation. On the contrary, the macrocirculation in diabetic patients may not correlate with tissue oxygenation because of structural changes in the capillary basement membrane. Nevertheless, many medical professionals in Korea rely on macrocirculation evaluation when predicting wound healing potential of the diabetic ulcers. The purpose of this study is to compare reliability of two common macrocirculation assessment methods, Doppler probing and CT angiography, on tissue oxygenation in diabetic foot patients. METHODS: Doppler and CT angiography scores were given according to the patency of the anterior and posterior tibial arteries. Tissue oxygenation was measured by transcutaneous partial oxygen tension(TcpO2). Doppler and CT angiography scores were statistically analyzed against TcpO2 values. Sixty-eight diabetic foot ulcer patients were included in this study.
RESULTS
The test was carried out on Doppler score and TcpO2 variables displayed a p-value of 0.0202, and concluded that the two variables were statistically dependent. The test used to determine for linear trends between Doppler scores and TcpO2 variables displayed a p-value of 0.0149, displaying statistical linear trend between the two variables. On the contrary, the tests between CT angiography scores and TcpO2 variables showed p-values of 0.1242 and 0.6590, that means no correlation between CT angiography and TcpO2 scores.
CONCLUSION
Doppler probing is more reliable than CT angiography in predicting tissue oxygenation of diabetic foot ulcers.

Keywords: Diabetic foot; Tissue oxygenation; Doppler; CT angiography

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