Correlation Between Pedal Acceleration Time and Transcutaneous Oxygen Pressures – A Prognostic Tool for Wound Healing in the Diabetic Foot Population

Abstract

INTRODUCTIONPedal arch interrogation by ultrasound through systolic acceleration time measurement (Pedal Acceleration Time – PAT) is a recently described technique, that offers valuable insights into foot hemodynamics. Previous studies have demonstrated a correlation between PAT and the ankle-brachial index (ABI) and PAT has been proposed as a prognostic tool for wound healing in patients with peripheral artery disease (PAD). This study aims to assess the correlation between PAT and Transcutaneous Oxygen Pressures (TcPO2) in the diabetic foot population. STUDY DESIGNSingle-center cross-sectional study. MATERIALS AND METHODSPedal acceleration time and transcutaneous oxygen pressures were measured in 60 limbs of 53 diabetic patients with ischemic foot ulcers. The assessment of wound status was performed between the 12th and 16th week after the first evaluation. The primary outcome was to assess the correlation between the values obtained for PAT and TcPO2. The secondary outcome was to establish a cut-off value for wound healing. RESULTSSixty limbs with ischemic foot ulcers were evaluated. The results showed a correlation between PAT and TcPO2 [F(1.52)=16.928; R2=0.246; p<0.001]. The ROC analysis showed an optimal cut-off value at PAT>186 ms for predicting a non-healing ulcer with a 96% specificity (AUC=0.774; CI 0.648-0.872; p<0.001). CONCLUSIONPAT showed a significant correlation with TcPO2 with high specificity to identify non-healing foot ulcers due to insufficient foot perfusion with a potential prognostic value in the diabetic foot population.