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· DOS Abstracts
Postoperative oxygenation and metabolism of the
soft tissue covering total ankle replacement
Frank Linde, Niels Christian Jensen, Kristian Kibak Nielsen,
Hanne Birke-Sørensen
Department of Orthopaedics, University Hospital of Aarhus
Background:
Up to one third of total ankle replacements (TAR) are followed
by wound healing complications. Even minor complications are potentially cata-
strophic as they may lead to loss of the prosthesis.
Purpose / Aim of Study:
The aim was to obtain knowledge regarding the oxy-
gen pressure and the metabolism in the soft tissue after TAR.
Materials and Methods:
Fifteen TAR patients were included. Transcutaneous
oxygen tension (tcpO2) was measured at both sides of the incision site preop-
eratively, 3 hours postoperatively and daily the following 6 days or until dis-
charge from the hospital and finally at 3 weeks follow-ups. Microdialysis cath-
eters were placed subcutaneously at both sides of the incision during the opera-
tion. Samples for analysis of the local metabolism were harvested each half hour
for 3 hours after the operation and then every 2 hours during daytime
Findings / Results:
TcpO2 was normal the first 3 hours postoperatively. At the
2nd postoperative day it has dropped to median 20% of the preoperative values
and stayed low until the 4th day. Day 6 it has increased to median 45%, and 3
weeks postoperatively it had reached a normal level. No sign of anaerobic me-
tabolism was found, and none of the 15 patients developed skin complications.
Conclusions:
The oxygen tension in the soft tissue adjacent to the skin incision
after TAR may be critical low during the 2nd to 4th day after operation. These
data may serve as guide for timing and duration of interventions for optimiza-
tion postoperative care after TAR and other major foot operations.
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