Tissue oxygenation, perfusion, and position in patients with venous leg ulcers

Objectives. The purpose of this study was to compare the partial pressure of transcutaneous tissue oxygen (TcPO(2)) in persons with venous ulcers in four positions with and without inspired oxygen. Methods: TcPO(2) was evaluated two times, 4 weeks apart at a chest reference and three lower extremity sites. Results: Lower extremity resting TcPO(2) levels were lower in patients with venous ulcers than in healthy adults. Minimal changes in TcPO(2) occurred with position changes when subjects breathed room air. When arterial oxygen saturation was increased using inspired oxygen, TcPO(2), used as an Indicator of perfusion, was lower during leg elevation, siding, and standing compared to lying supine (p < 0.05). Conclusions: Control of peripheral circulation and tissue oxygenation may be impaired in persons with venous ulcers. Leg elevation, sifting, and standing decreased wound perfusion and may not be beneficial to individuals with venous insufficiency and ulceration. Research is needed to explore relationships among tissue oxygenation, blood perfusion, compression, positioning, and venous ulcer healing.