The use of hemoglobin saturation ratio as a means of measuring tissue perfusion in the development of heel pressure sores

• Published in: Surgical technology international Vol. 23; p. 69
• Main Authors: Aliano, Kristen A, Stavrides, Steve, Davenport, Thomas
• Format: Magazine Article
• Language: English
• Published: United States 01.09.2013
• Subjects: Blood Flow Velocity; Diagnosis, Computer-Assisted - methods; Female; Heel - physiopathology; Hemoglobins - analysis; Hemoglobins, Abnormal; Humans; Male; Oximetry - methods; Oxygen - blood; Pressure Ulcer - diagnosis; Pressure Ulcer - physiopathology; Reproducibility of Results; Sensitivity and Specificity; Young Adult
• ISSN: 1090-3941

The heel is a common site of pressure ulcers. The amount of pressure and time needed to develop these wounds is dependent on various factors including pressure surface, the patient's anatomy, and co-morbidities. We studied the use of the hemoglobin saturation ratio as a means of assessing heel perfusion in various pressure settings. The mixed perfusion ratio in the heels of 5 volunteers was assessed on 3 pressure surfaces and at the time of off-load. The surfaces studied included: stretcher pad, plastic backboard without padding, and pressure reduction gel. Each surface was measured for 5 minutes with a real-time reading. On the stretcher, the average StO2% decrease for each pressure surface was 26.2 ± 10 (range 18-43). The average StO2% decrease on the backboard was 22.8 ± 12.3 (range 8-37), and 24.0 ± 4.8 (range 19-30) on the gel pad. The StO2% drop plateaued with the stretcher and gel pad, but with the backboard there was a continued slow drop at 5 minutes. This study demonstrates that hemoglobin oxygenation ratio may be effective in assessing a tissue's direct perfusion in the setting of tissue pressure and may also be beneficial to better assess the effects of pressure-reduction surfaces. Further studies will be needed to determine time to skin breakdown as it pertains to pressure and tissue oxygenation.