Transcutaneous oxygen measurement (TCOM or TcPO
2) is a non-invasive method of measuring the
oxygen
Oxygen is a chemical element; it has chemical symbol, symbol O and atomic number 8. It is a member of the chalcogen group (periodic table), group in the periodic table, a highly reactivity (chemistry), reactive nonmetal (chemistry), non ...
level of the tissue below the skin. Since oxygen is carried by the blood, TCOM can be used as an indirect measure of
blood flow
Hemodynamics American and British English spelling differences#ae and oe, or haemodynamics are the Fluid dynamics, dynamics of blood flow. The circulatory system is controlled by homeostasis, homeostatic mechanisms of autoregulation, just as hydrau ...
to the tissue. Since blood flow is important for
wound healing
Wound healing refers to a living organism's replacement of destroyed or damaged tissue by newly produced tissue.
In undamaged skin, the epidermis (surface, epithelial layer) and dermis (deeper, connective layer) form a protective barrier again ...
, TCOM is often used to gauge the ability of tissue to effectively heal.
To perform the test, one set of electrodes are placed on viable tissue (e.g. the chest) as a control and a second set is placed around the tissue in question (e.g. legs or feet). The electrodes may mildly heat the skin to increase blood flow into the area. Oxygen may also be given to the patient to see if that increases oxygen levels in the tissue. The test takes about 45 minutes. Results are reported either as the absolute values of the tissue in question (in
mmHg
A millimetre of mercury is a manometric unit of pressure, formerly defined as the extra pressure generated by a column of mercury one millimetre high. Currently, it is defined as exactly , or approximately 1 torr = atmosphere = &nb ...
) or as a ratio of the tissue in question to the control tissue. The normal oxygen tension in the foot is approximately 60 mmHg, and the normal chest/foot ratio is approximately 0.9. Many factors can limit the accuracy of the test including
edema
Edema (American English), also spelled oedema (British English), and also known as fluid retention, swelling, dropsy and hydropsy, is the build-up of fluid in the body's tissue (biology), tissue. Most commonly, the legs or arms are affected. S ...
, temperature, inflammation, medications, and stress. In addition for the measurement to be normal, all parts of the oxygenation pathway must be functioning: the lungs must be able to oxygenate the blood, the heart must be able to pump the blood, and a patent artery must be able to carry blood to the skin.
Without comorbidities, wounds are thought to be able to heal if the oxygen tension is greater than 40 mmHg.
In the presence of comorbidities, such as diabetes or edema, a higher value is likely needed. Patients with oxygen tensions less than 20 mmHg are likely to need
revascularization
In medical and surgical therapy, revascularization is the restoration of perfusion to a body part or organ that has had ischemia. It is typically accomplished by surgical means. Vascular bypass and angioplasty are the two primary means of r ...
to promote adequate wound healing.
[ ] The required TCOM level for adequate wound healing, however, remains controversial.
References
{{Authority control
Medical tests