Tissue Oxygenation Measurements to Aid Scalpel Debridement Removal in Patients
with Diabetes.
Authors Kaile K, Mahadevan J, Leiva K, Khandavilli D, Narayanan S, Muthukrishnan V, Wu
W, Mohan V, Godavarty A
Submitted By Anuradha Godavarty on 5/5/2021
Status Published
Journal Journal of diabetes science and technology
Year 2021
Date Published 2/1/2021
Volume : Pages Not Specified : 1932296821
PubMed Reference 33615851
Abstract Callus formation in the diabetic foot increases the risk of ulcer onset. It is
standard procedure to remove these dead tissue layers to reduce rising
pressures. In a surgical procedure known as scalpel debridement, or chiropody
the callus tissue is removed up to the epidermal layer. Factors may influence
the outcome of this surgical process such as clinician inexperience. In an
effort to standardize the debridement process, tissue oxygenation (TO)
measurements are obtained before and after to study the effect of debridement on
callus tissue., Fifteen debridement cases were analyzed using near infrared
(NIR) imaging to study changes in TO. The NIR-based device used in this study
estimates effective changes in TO in terms of oxy-, deoxy-, total hemoglobin,
and oxygen saturation. Weber contrasts between callus tissue and the surrounding
normal tissue were compared following debridement for all TO parameters. In a
secondary analysis, callus tissue was segmented into quadrants and a percent of
significance (in terms of total TO change) was calculated using a t-test.,
Results show majority of cases displayed greater than 80% as the significant
change in TO following debridement, except in cases with the presence of blood
clot (a common precursor for ulceration). In cases where incomplete debridement
was suspected, a significant change in TO was still observed., With extensive
systematic studies in the future, NIR imaging technique to measure changes in TO
may be implemented as a low-cost hand-held imaging device useful for objectively
assessing the effectiveness of the scalpel debridement process.