Transcutaneous oxygen and carbon dioxide measurements for determination of skin graft 'take'

The feasibility of using transcutaneous partial pressure of oxygen (TCPO₂) and transcutaneous partial pressure of carbon dioxide (TCPCO₂) measurements as a way of determining skin graft 'take' was investigated in 13 patients who received partial-thickness sheet grafts. Transcutaneous measurements were obtained from the graft and an area of normal skin starting on the day of surgery and then daily for 2 weeks. No complications or discomfort resulted from the determinations. Initially, graft TCPO₂ was extremely low (<8 mm Hg) and never rose above a value of 30 to 40 mm Hg, whereas skin levels ranged between 60 and 80 mm Hg. Graft TCPO₂ levels never approached skin levels until graft maturity was achieved. Graft TCPCO₂ levels were 80 to 100 mm Hg on the first few days after grafting but decreased to levels just above those of the skin (40 to 50 mm Hg) by 5 to 6 days after grafting. Graft TCPCO₂ normalized at the time of clinical graft vascularization and remained levels just above those of the skin throughout the remainder of the study. Graft TCPCO₂ determinations provide a noninvasive and objective measure of skin graft vascularization, and graft TCPO₂ values reflect graft maturity.