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Sheffield PJ. Measuring tissue oxygen tension: a review. Undersea Hyper Med 1998; 25(3):179-188.-Because of technological advances in tissue oximetry, clinicians and scientists have a better understanding of the role of oxygen in wound healing. In wound care and hyperbaric medicine applications, an oximeter is principally used with vascular assessment to help determine amputation level and to estimate healing potential. With the current emphasis on cost savings in the managed care setting, transcutaneous oximetry (Ptc0^sub 2^) has gained importance as a tool for predicting potential candidates for hyperbaric oxygen (HBO^sub 2^) therapy. It is used to identify the presence of hypoxia in wounded tissue, to predict the responders to hyperoxia and in some instances to determine when HBO^sub 2^ treatment is complete. This literature review describes the principal current methods for measuring tissue 02 and the values obtained in normal and wounded tissue under both normobaric and hyperbaric conditions. The review includes the Jefferson C. Davis Wound Care and Hyperbaric Medicine Center protocol for PtcO^sub 2^ assessment of potential HB0^sub 2^ candidates and suggestions for obtaining reproducible Ptc0^sub 2^ data.
tissue oxygen measurement, tissue oxygen tension, oxygen electrodes, normal oxygen tension, wound oxygen tension, transcutaneous oximetry, oxygen in wound healing, vascular assessment
Much has been written about the role of oxygen in wound healing and the technological developments to measure it. Hunt (1) and Nnikoski (2) demonstrated the hypoxic nature of wounds and postulated that healing and incidence of infection were related to 0^sub 2^ supply. Silver (3) precisely analyzed the environment in and around experimental wounds and revealed an 0^sub 2^ gradient between the dead space of the wound and the wound edge. Investigations of severely hypoxic wounds in animal models suggested that elevation of 0^sub 2^tension up to normal would enhance healing, since the rate of healing is 0^sub 2^ dependent (4). Direct relationships have been demonstrated between wound 0^sub 2^ tension and production of collagen (5), epithelialization (6), resistance to infection (7), and promotion of healing (1,7,8). Because of technological advances in 0^sub 2^ monitoring, clinicians and scientists now have a better understanding of wound healing mechanisms and the role of 0^sub 2^ in wound healing.
Sheffield (9) demonstrated that hyperbaric oxygen (HBO^sub 2^) elevated 0^sub 2^ tension in severely...