Transcutaneous Po₂ measurement in compound fractures

The transcutaneous assessment of tissue oxygenation has become a useful method for evaluating microcirculatory disorders in different diseases. In this clinical experimental pilot study, the impact of compound fractures on tissue oxygenation was examined. Using a special probe placed directly into the muscle, tissue oxygenation was measured at the site of tissue injury as well as at one non-injured site within the same fractured extremity. A non-injured extremity was also measured as a control. At the injured site tissue oxygenation was significantly increased during the first 4 days after trauma compared with the non-injured extremity (40.7 ± 1.8 mmHg versus 23.5 ± 4.1 mmHg). At the same time the non-injured site of the fractured extremity appeared to be significantly less oxygenated compared with the noninjured extremity (13.2 ±2.3 mmHg versus 23.5 ± 4.1 mmHg). After day 4 until the end of the study (day 10) a complete return to normal values was noted at both sites. In conclusion, it is most likely that, due to a change of microcirculation within the fractured extremity, the injured site is temporarily oversaturated by oxygen and this is associated with low oxygenation at the non-injured site on the same extremity. As the microcirculatory status may be important in making decisions about trauma surgery (e.g. whether or not to amputate), transcutaneous oxygen measurement is a practical and useful method in trauma care.