Abstract
There is continued debate as to whether skin damage in venous disease results from an oxygen diffusion block or from abnormal perfusion.
Transcutaneous oxygen pressure and laser-Doppler flux were measured in 15 patients with chronic venous insuffiency (CVI) and lipodermatosclerosis and in 15 normal controls. The time for TcPo 2 to regain resting values after 5 min of ischaemia was measured, as was the time taken for laser-Doppler flux to reach 95% of peak flow.
TcPo 2 was reduced in patients with CVI (median 26 mmHg, interquartile range (IQR) 16–46) compared to controls (median 55 mmHg, IQR 40–65). Hyperaemic responsiveness, as assessed by calculating the ratio of peak laser-Doppler flux following 5 min of ischaemia, was also reduced (median (CVI) 1.5, IQR 1.1–2; median (control 3.3, IQR 1.8–4.8). However, following ischaemia TcPo 2 took no longer to regain resting levels in venous patients than in controls, whereas there was a trend towards delay in reaching peak skin blood flow.
These findings suggest a primary perfusion deficit in skin damaged by venous hypertension rather than an oxygen diffusion block.
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