Transcutaneous Oxygen Pressure as an Early Prognostic Marker for Wound Healing and Limb Salvage in Revascularization for Peripheral Arterial Disease: A Prospective Cohort Study

Background The ankle-brachial index (ABI) is frequently unreliable for perfusion assessment in chronic limb-threatening ischemia (CLTI), particularly in patients with medial arterial calcification. This study evaluated the prognostic value of transcutaneous oxygen pressure (TcPO 2 ) for predicting wound healing and limb salvage following revascularization for peripheral arterial disease (PAD). Methods This prospective, single-center observational cohort study included 100 patients with PAD undergoing surgical, endovascular, or hybrid revascularization. TcPO 2 and ABI were assessed preoperatively and at 24 hours, 6 months, and 12 months postoperatively. Clinical severity was classified using the Rutherford classification, with WIfI staging in patients with tissue loss and GLASS lesion complexity staging. The primary outcome was the change in TcPO 2 (ΔTcPO 2 ) from baseline at the defined follow-up intervals. Secondary outcomes included the association of TcPO 2 and ΔTcPO 2 with wound healing in patients with tissue loss. Results Ninety-eight patients were analyzed, including 54 with CLTI. Median preoperative TcPO 2 was 31 mmHg (interquartile range [IQR] 22). TcPO 2 increased significantly over time in both CLTI and non-CLTI cohorts (p