Transcutaneous oxygen monitoring for predicting skin viability in dogs

Mark C. Rochat From the Departments of Veterinary Medicine and Surgery (Rochat, Pope, Payne) and Veterinary Pathology (Pace), College of Veterinary Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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Eric R. Pope From the Departments of Veterinary Medicine and Surgery (Rochat, Pope, Payne) and Veterinary Pathology (Pace), College of Veterinary Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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John T. Payne From the Departments of Veterinary Medicine and Surgery (Rochat, Pope, Payne) and Veterinary Pathology (Pace), College of Veterinary Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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Lanny W. Pace From the Departments of Veterinary Medicine and Surgery (Rochat, Pope, Payne) and Veterinary Pathology (Pace), College of Veterinary Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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Colette C. Wagner-Mann From the Departments of Veterinary Medicine and Surgery (Rochat, Pope, Payne) and Veterinary Pathology (Pace), College of Veterinary Medicine, and the Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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SUMMARY

Transcutaneous oxygen (PO2-TC) monitoring is commonly used in human medicine for evaluating skin viability. The application of transcutaneous monitoring for evaluating skin viability in dogs was investigated.

The changes in PO2-TC values were measured from 16 avascular skin flaps created along the lateral hemithoraces of 4 dogs. Transcutaneous oxygen values were serially recorded from the vascular base and avascular apex of each flap for 12 hours after surgery. A single transcutaneous measurement was obtained from each flap base and apex 24 hours after surgery. Serial arterial blood gas analyses were obtained to compare central oxygen values with PO2-TC values. Full-thickness skin biopsy specimens were harvested from the base and apex of each flap 24 hours after surgery. The flaps were observed for 4 days and then excised for histologic examination. A subjective grading scale was used to assess histologic changes.

Throughout the 12-hour period and at 24 hours, a statistically significant difference was found between the PO2-TC values for apices and bases of the flaps. The mean PO2-TC for all bases was 90.9 mm of Hg ± 3.3 SEM, and the mean PO2-TC for all apices was 21.2 mm of Hg ± 1.8 SEM. The mean regional perfusion index (apex PO2-TC/base PO2-TC) was 0.23 ± 0.02. The subjective numbers assigned to the biopsy specimens were statistically evaluated by using a paired Student's t test and a Wilcoxon signed-rank test. A significant difference was found between the numbers for the collective bases and apices with both tests. A statistically significant difference was found between the numbers for the apex biopsy specimens taken 24 hours after creation of the skin flap and those taken when the flap was excised, whereas no difference was found between the numbers for the base biopsy specimens. On the basis of our findings, PO2-tc monitoring is a useful technique for assessing skin viability in dogs.

SUMMARY

Transcutaneous oxygen (PO2-TC) monitoring is commonly used in human medicine for evaluating skin viability. The application of transcutaneous monitoring for evaluating skin viability in dogs was investigated.

The changes in PO2-TC values were measured from 16 avascular skin flaps created along the lateral hemithoraces of 4 dogs. Transcutaneous oxygen values were serially recorded from the vascular base and avascular apex of each flap for 12 hours after surgery. A single transcutaneous measurement was obtained from each flap base and apex 24 hours after surgery. Serial arterial blood gas analyses were obtained to compare central oxygen values with PO2-TC values. Full-thickness skin biopsy specimens were harvested from the base and apex of each flap 24 hours after surgery. The flaps were observed for 4 days and then excised for histologic examination. A subjective grading scale was used to assess histologic changes.

Throughout the 12-hour period and at 24 hours, a statistically significant difference was found between the PO2-TC values for apices and bases of the flaps. The mean PO2-TC for all bases was 90.9 mm of Hg ± 3.3 SEM, and the mean PO2-TC for all apices was 21.2 mm of Hg ± 1.8 SEM. The mean regional perfusion index (apex PO2-TC/base PO2-TC) was 0.23 ± 0.02. The subjective numbers assigned to the biopsy specimens were statistically evaluated by using a paired Student's t test and a Wilcoxon signed-rank test. A significant difference was found between the numbers for the collective bases and apices with both tests. A statistically significant difference was found between the numbers for the apex biopsy specimens taken 24 hours after creation of the skin flap and those taken when the flap was excised, whereas no difference was found between the numbers for the base biopsy specimens. On the basis of our findings, PO2-tc monitoring is a useful technique for assessing skin viability in dogs.

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